Methods of delivering a neuroprotective polypeptide to the central nervous system

ABSTRACT

The present disclosure provides a method for delivering a neuroprotective polypeptide to at least a portion of a central nervous system (CNS) of a subject. The method includes administering to the systemic blood circulation of the subject a therapeutically effective amount of a neuroprotective polypeptide by a controlled-release formulation or a device providing a sustained release of the neuroprotective polypeptide including at least one neuroprotective polypeptide selected from the group consisting of GLP-1, exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue; the neuroprotective polypeptide binds to and activates a receptor that binds at least one of GLP-1, exendin-4, or a combination thereof; and the controlled-release neuroprotective formulation or the sustained release of the neuroprotective polypeptide enhances the delivery of the neuroprotective polypeptide across a blood-brain barrier (BBB) of the subject to at least a portion of the CNS relative to a rapid release formulation of the neuroprotective polypeptide. Also disclosed is a method of treating a subject with a CNS-related disease or reducing at least one symptom of a CNS-related disease in a subject in need thereof.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.62/410,748, filed 20 Oct. 2016, the contents of which are incorporatedherein by reference in their entirety.

GOVERNMENT FUNDING

Research supporting this application was carried out by the UnitedStates of America as represented by the Secretary, Department of Healthand Human Services. The Government has certain rights in this invention.

INCORPORATION BY REFERENCE

In compliance with 37 C.F.R. § 1.52(e)(5), the sequence informationcontained in electronic file name:1568390_100WO2_Sequence_Listing_ST25.txt; size 24.4 KB; created on: 3Sep. 2017, using Patent-In 3.5, and Checker 4.4.0 is hereby incorporatedherein by reference in its entirety.

BACKGROUND Field

The present disclosure relates to compositions comprising aneuroprotective therapeutic polypeptide, such as, e.g., glucagon-likepeptide-1 (GLP-1), exendin-4, and/or their peptide analogs. Inparticular, the present disclosure relates to methods to maintain asteady-state plasma level of the neuroprotective therapeutic polypeptideto facilitate delivery to the brain across the blood-brain barrier (BBB)for the treatment of a neurodegenerative condition.

Background Art

Glucagon-like peptide-1 (GLP-1), a hormone normally secreted byneuroendocrine cells of the gut in response to food, has been suggestedas a new treatment for type 2 diabetes (Gutniak et al., 1992; Nauck etal., 1993). It increases insulin release by beta cells even in subjectswith long-standing type 2 diabetes (Nauck et al., 1993). GLP-1 treatmenthas an advantage over insulin therapy because GLP-1 stimulatesendogenous insulin secretion, which turns off when blood glucose levelsdrop (Nauck et al., 1993; Elahi et al., 1994). GLP-1 promotes euglycemiaby increasing insulin release and synthesis, inhibiting glucagonrelease, and decreasing gastric emptying (Nauck et al., 1993; Elahi etal., 1994; Wills et al., 1996; Nathan et al., 1992; De Ore et al.,1997). GLP-1 is a product of posttranslational modification ofproglucagon. The sequences of GLP-1 and its active fragments GLP-1(7-37) and GLP-1(7-36) amide are known in the art (Fehmann et al.,1995). Although GLP-1 has been proposed as a therapeutic agent in thetreatment of diabetes, it has a short biological half-life (De Ore etal., 1997), even when given by a bolus subcutaneously (Ritzel et al.,1995). GLP-1 degradation (and GLP-1 (7-36) amide), in part, is due tothe enzyme dipeptidyl peptidase (DPP 1V), which cleaves the polypeptidebetween amino acids 8 and 9 (alanine and glutamic acid).

Exendin-4 is a polypeptide produced in the salivary glands of the Gilamonster lizard (Goke et al., 1993). The amino acid sequence forexendin-4 is known in the art (Fehmann et al. 1995). Although it is theproduct of a uniquely non-mammalian gene and appears to be expressedonly in the salivary gland (Chen and Drucker, 1997), exendin-4 shares a52% amino acid sequence homology with GLP-1 and in mammals interactswith the GLP-1 receptor (Goke et al., 1993; Thorens et al., 1993). Invitro, exendin-4 has been shown to promote insulin secretion by insulinproducing cells and, given in equimolar quantities, is more potent thanGLP-1 at causing insulin release from insulin producing cells.Furthermore, exendin-4 potently stimulates insulin release to reduceplasma glucose levels in both rodents and humans and is longer actingthan GLP-1. Exendin-4, however, because it does not occur naturally inmammalians, has certain potential antigenic properties in mammals thatGLP-1 lacks.

In addition to the reduction in insulin production that occurs indiabetes, peripheral neuropathy is commonly associated with diabetes.Twenty to thirty percent of all diabetes subjects eventually developperipheral neuropathy. Furthermore, there are reports of increased riskof Alzheimer's disease with heart disease, stroke, hypertension, anddiabetes (Moceri et al., 2000; Ott et al., 1999). Thus, diabetes is adisease that is also associated with neurodegenerative diseases.

The GLP-1 receptor is present in both the rodent (Jin et al. 1988,Shughrue et al. 1996, Jia et al. 2015) and human (Wei and Mojsov 1995,Satoh et al. 2000) brains. The chemoarchitecture of the distributionappears to be largely confined to the hypothalamus, thalamus, brainstem,lateral septum, the subfomical organ and the area postrema, allcircumventricular areas where generally large numbers of peptidereceptors are located. However, specific binding sites for GLP-1 havealso been detected throughout the caudate-putamen, cerebral cortex andcerebellum (Campos et al. 1994, Calvo et al. 1995, and Goke et al.1995), albeit at lower densities. For example, Lu et al. 2014demonstrated that GLP-1 receptor is expressed in amygdata, cerebellum,frontal cortex, hippocampus, hypothalamus, midbrain, medulla, pons,striatum, thalamus and themporal cortex of Mustela putorius furo(ferrets). GLP-1 receptor expression level in the brain is not affectedby aging.

Furthermore, GLP-1 has been shown to be related to cognition andbehavior. (During et al. 2003). In fact, a number of studies havesuggested GLP-1 receptor agonists as a new treatment forneurodegenerative diseases including Parkinson's disease, Alzheimer'sdisease, Huntington's disease, traumatic brain injury, stroke, andperipheral neuropathy. However, drug delivery to the central nervoussystem (CNS) across the blood-brain barrier (BBB) is a substantialhurdle for the treatment of CNS-related diseases. For example, GLP-1 hasa short half-life of 1-2 minutes and GLP-1-Transferrin fusion protein(GLP-1-Tf), which was produced to resist inactivation and thus increasethe half-life of GLP-1 to approximately 2 days, is incapable of crossingthe BBB. Kim et al. 2010 and Martin et al. 2012.

Additionally, while Exendin-4 has been shown to improve RotaRodPerformance, as compared to GLP-1-Tf (Martin et al. 2012), and is knownto enter the brain from the blood, the entry rate is limited (Kastin A Jand Akeerstrom V, International Journal of Obesity (2003) 27, 313-318).Furthermore, Exenatide has been shown to be ineffective at providingneuroprotection in the MPTP mouse model for Parkinson's disease whenprovided with post treatments, daily for seven days (Liu et al. 2015).

As such, a need exists in the art for a method for treatingneurodegenerative conditions, as well as a method of maintaining asteady-state plasma level of a neuroprotective GLP-1 receptor agonist,thereby facilitating and driving drug delivery to the central nervoussystem across the BBB.

SUMMARY

In an aspect of the present disclosure, a method for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprising: administering to thesystemic blood circulation of the subject a therapeutically effectiveamount of neuroprotective polypeptide by a controlled-releaseformulation or a device providing a sustained release or delivery of theneuroprotective polypeptide, the neuroprotective polypeptide includes atleast one neuroprotective polypeptide selected from the group consistingof GLP-1, exendin-4, or a therapeutically effective GLP-1 or exendin-4analogue, wherein the neuroprotective polypeptide binds to and activatesa receptor that binds at least one of GLP-1, exendin-4, or a combinationthereof; and wherein the controlled-release neuroprotective formulationor sustained release of the neuroprotective polypeptide enhances thedelivery and/or uptake of the neuroprotective polypeptide across ablood-brain barrier (BBB) of the subject to at least a portion of thecentral nervous system (CNS) relative to a rapid release formulation ofthe neuroprotective peptide.

In another aspect of the present disclosure, a method of treating asubject with a central nervous system (CNS)-related disease or reducingat least one symptom of a CNS-related disease in a subject in needthereof. The method comprising: administering to the systemic bloodcirculation of the subject a therapeutically effective amount of aneuroprotective polypeptide by a controlled-release formulation or adevice providing a sustained release or delivery of a neuroprotectivepolypeptide, wherein the neuroprotective polypeptide includes at leastone neuroprotective polypeptide selected from the group consisting ofGLP-1, exendin-4, or a therapeutically effective GLP-1 or exendin-4analogue, wherein the neuroprotective polypeptide binds to and activatesa receptor that binds at least one of GLP-1, exendin-4 or a combinationthereof; and wherein the controlled-release neuroprotective formulationor a device enhances the delivery of the neuroprotective polypeptideacross a blood-brain barrier (BBB) of the subject to at least a portionof the central nervous system (CNS) relative to a rapid releaseformulation of the neuroprotective polypeptide.

In an aspect of the present disclosure, a method for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject is provided. The method comprisesadministering a controlled-release neuroprotective formulation to thesystemic blood circulation of the subject. In an embodiment, thecontrolled-release neuroprotective formulation includes at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin (e.g. exendin-4), or a therapeutically effective GLP-1 orexendin analogue (e.g. exendin-4 analogue), wherein the neuroprotectivepolypeptide binds to and activates a receptor that binds at least one ofGLP-1, exendin (such as exendin-4), or a combination thereof, and thecontrolled-release neuroprotective formulation enhances the delivery ofthe neuroprotective polypeptide across a blood-brain barrier (BBB) ofthe subject to at least a portion of the central nervous system (CNS)relative to rapid release formulation of the neuroprotectivepolypeptide.

In certain embodiments, the controlled-release formulation is a longacting formulation of the neuroprotective polypeptide.

In other embodiments, the long acting formulation comprises a depotformulation for sustained release of the neuroprotective polypeptide.

In particular embodiments, the long acting formulation comprises acomposition for sustained release of the neuroprotective polypeptide.

In additional embodiments, the controlled-release formulation furthercomprises a biodegradable polymer with a specific viscosity and coatingmaterials, having bioavailability and sustained release of theneuroprotective polypeptide in an effective concentration for a certainperiod.

In particular embodiments, the controlled-release neuroprotectiveformulation comprises: a controlled-release microsphere that includes acore with the neuroprotective polypeptide and a biodegradable polymer;and a coating layer that coats the core.

In an embodiment, administering the controlled-release neuroprotectiveformulation alleviates at least one symptom of at least one CNS-relatedcondition in the subject.

In further embodiments, the CNS-related condition is selected from thegroup consisting of Parkinson's disease (PD), traumatic brain injury(TBI), multiple sclerosis, drug addiction, alcohol addiction,neurodegenerative conditions, inflammation of a brain, Alzheimer'sdisease (AD), multiple system atrophy, Huntington's disease, chronictraumatic encephalopathy (CTE), motor neuron diseases (e.g., amyotrophiclateral sclerosis, spinal cord injury, spinocerebellar ataxia (SCA),spinal muscular atrophy (SMA)), vascular dementia, dementia with Lewybodies (DLB), mixed dementia, frontotemporal dementia, Creutzfeldt-Jakobdisease, normal pressure hydrocephalus, or a combination thereof.

In a certain embodiment, administering a controlled-releaseneuroprotective formulation comprises injecting the controlled-releaseneuroprotective formulation.

In additional embodiments, injecting the controlled-releaseneuroprotective formulation is a subcutaneous injection. For example,administering a controlled-released neuroprotective formulation cancomprise subcutaneously injecting the controlled-release neuroprotectiveformulation.

In another embodiment, administering the controlled-releaseneuroprotective formulation results in a steady-state plasmaconcentration of the neuroprotective polypeptide in a range of about 50to about 4500 pg/mL.

In other embodiments, administering the controlled-releaseneuroprotective formulation results in a cumulative increase in theneuroprotective polypeptide concentration in the cerebrospinal fluid(CSF), the brain or a combination thereof in the subject.

In particular embodiments, the neuroprotective polypeptide concentrationin the CSF is within the range of about 5 to about 400 pg/mL (e.g.,about 10 to about 400 pg/mL).

In an additional aspect, a method of treating a subject with aCNS-related disease or reducing at least one symptom of a CNS-relateddisease in a subject in need thereof is provided. The method comprisesadministering to the subject a therapeutically effective amount of acontrolled-release neuroprotective formulation to the systemic bloodcirculation of the subject. The controlled-release neuroprotectiveformulation includes at least one neuroprotective polypeptide selectedfrom the group consisting of GLP-1, exendin (such as exendin-4), or atherapeutically effective GLP-1 or exendin (such as exendin-4) analogue;the neuroprotective polypeptide binds to and activates a receptor thatbinds at least one of GLP-1, exendin (e.g. exendin-4) or a combinationthereof; and the controlled-release neuroprotective formulation enhancesthe delivery of the neuroprotective polypeptide across a BBB of thesubject to at least a portion of the CNS relative to a rapid releaseformulation of the neuroprotective polypeptide.

In certain embodiments, the controlled-release formulation is a longacting formulation of the neuroprotective polypeptide.

In other embodiments, the long acting formulation comprises a depotformulation for sustained release of the neuroprotective polypeptide.

In additional embodiments, the long acting formulation comprises acomposition for sustained release of the neuroprotective polypeptide.

In additional embodiments, the controlled-release formulation furthercomprises a biodegradable polymer with a specific viscosity and coatingmaterials, having bioavailability and sustained release of theneuroprotective polypeptide in an effective concentration for a certainperiod.

In particular embodiments, the controlled-release neuroprotectiveformulation comprises: a controlled-release microsphere that includes acore with the neuroprotective polypeptide and a biodegradable polymer;and a coating layer that coats the core.

In a particular embodiment, administering the controlled-releaseneuroprotective formulation alleviates at least one symptom of at leastone CNS-related condition in the subject.

In an embodiment, the CNS condition is selected from the groupconsisting of Parkinson's disease (PD), traumatic brain injury (TBI),multiple sclerosis, drug addiction, alcohol addiction, neurodegenerativeconditions, inflammation of a brain, Alzheimer's disease (AD), multiplesystem atrophy, Huntington's disease, chronic traumatic encephalopathy,motor neuron diseases (e.g., amyotrophic lateral sclerosis, spinal cordinjury, spinocerebellar ataxia (SCA), spinal muscular atrophy (SMA)),vascular dementia, dementia with Lewy bodies (DLB), mixed dementia,frontotemporal dementia, Creutzfeldt-Jakob disease, normal pressurehydrocephalus, or a combination thereof.

In further embodiments, administering the controlled-releaseneuroprotective formulation comprises injecting the controlled-releaseneuroprotective formulation to the subject.

In certain embodiments, injecting the controlled-release neuroprotectiveformulation to the subject is a subcutaneous injection.

In additional embodiments, administering the controlled-releaseformulation results in a steady-state plasma concentration of theneuroprotective polypeptide that is in a range of about 50 to about 4500pg/mL.

In some embodiments, administering the controlled-release formulationresults in a cumulative increase in the neuroprotective polypeptideconcentration in at least one of the cerebrospinal fluid (CSF), thebrain, or a combination thereof.

In a further aspect, a method for delivering a neuroprotectivepolypeptide to at least a portion of a central nervous system (CNS) of asubject is provided. The method comprises: providing a sustaineddelivery to the systemic blood circulation of the subject at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue,wherein the neuroprotective polypeptide binds to and activates areceptor that binds at least one of GLP-1, exendin-4, or a combinationthereof; and wherein the controlled-release neuroprotective formulationenhances the delivery and/or uptake of the neuroprotective polypeptideacross a blood brain barrier (BBB) of the subject to at least a portionof the central nervous system (CNS) relative to a rapid releaseformulation of the neuroprotective peptide.

In yet another aspect, a method of treating a subject with a centralnervous system (CNS)-related disease or reducing at least one symptom ofa CNS-related disease in a subject in need thereof is provided. Themethod comprises: providing a sustained delivery to the systemic bloodcirculation of the subject at least one neuroprotective polypeptideselected from the group consisting of GLP-1, exendin-4, or atherapeutically effective GLP-1 or exendin-4 analogue, wherein theneuroprotective polypeptide binds to and activates a receptor that bindsat least one of GLP-1, exendin-4 or a combination thereof; and whereinthe controlled-release neuroprotective formulation enhances the deliveryof the neuroprotective polypeptide across a blood brain barrier (BBB) ofthe subject to at least a portion of the central nervous system (CNS)relative to a rapid release formulation of the neuroprotectivepolypeptide.

In an embodiments, providing the sustained release neuroprotectivepolypeptide or polypeptides includes administering the polypeptide(s)via a device (e.g., a pump, a mini-pump, an osmotic pump, an osmoticdelivery device, an infusion pump, an intravenous administration device,a peristaltic pump, a miniature infusion pump, or the like).

In certain embodiments, the neuroprotective polypeptide or polypeptidesis administered at a rate of about 1 pM/kg/min to about 30 pM/kg/min(e.g., about 3 pM/kg/min to about 17.5 pM/kg/min).

In other embodiments, administering the controlled-releaseneuroprotective formulation or providing a sustained delivery of theneuroprotective polypeptide alleviates at least one symptom of at leastone CNS-related condition in the subject.

In particular embodiments, the CNS-related condition is selected fromthe group consisting of Parkinson's disease (PD), traumatic brain injury(TBI), multiple sclerosis, drug addiction, alcohol addiction,neurodegenerative conditions, inflammation of a brain, Alzheimer'sdisease (AD), multiple system atrophy, Huntington's disease, chronictraumatic encephalopathy, motor neuron diseases (e.g., amyotrophiclateral sclerosis, spinal cord injury, spinocerebellar ataxia (SCA),spinal muscular atrophy (SMA)), vascular dementia, dementia with Lewybodies (DLB), mixed dementia, frontotemporal dementia, Creutzfeldt-Jakobdisease, normal pressure hydrocephalus, or a combination thereof.

In an embodiment, administering the controlled-release formulation orproviding the sustained release of the neuroprotective polypeptideresults in a steady-state plasma concentration of the neuroprotectivepolypeptide that is in a range of about 50 to about 4500 pg/mL.

In certain embodiments, administering the controlled-release formulationor providing the sustained release of the neuroprotective polypeptideresults in a cumulative increase in the neuroprotective polypeptideconcentration in at least one of the cerebrospinal fluid (CSF), thebrain, or a combination thereof.

In yet another embodiment, the neuroprotective polypeptide concentrationin the CSF is within the range of about 5 to about 400 pg/mL.

In some embodiments, the ratio of the steady-state polypeptideconcentration in the CFS to the plasma is in the range of about 0.1% toabout 5%.

In further embodiments, the neuroprotective polypeptide is selected fromthe group consisting of SEQ ID NOS: 1-55. For example, theneuroprotective polypeptide may comprise an amino acid sequence selectedfrom SEQ ID NOS: 1-55.

In other embodiments, the exendin-4 analogue is represented by ChemicalFormula I or its pharmaceutically acceptable salt:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 Xaa27 Xaa28-Z₁,   (Chemical Formula I)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala, or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, or a C1-C10straight chain or branched alkanoyl;

Xaa22 is Ala, Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

Xaa27 is Ala or Lys;

Xaa28 is Ala or Asn; and

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂,

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, or N-alkylalanine, Xaa39 is Ser, or Ty (e.g. Ser),and

Z₂ is —OH, or —NH₂,

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, Xaa26, Xaa27, and Xaa28 are Ala; and    -   when Xaa1 is His, Arg, or Tyr, at least one of Xaa3, Xaa4, and        Xaa9 is Ala.

In other embodiments, the exendin-4 analogue is represented by ChemicalFormula II or their pharmaceutically acceptable salts:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 X₁-Z₁,   (Chemical Formula II)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R (wherein, R is Lys, Arg, C1-C10 straightchain or branched alkanoyl, or cycloalleyl-alkanoyl);

Xaa22 is Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

X₁ is Lys Asn, Asn Lys, Lys-NHε-R Asn, Asn Lys-NHε-R, Lys-NHε-R Ala, AlaLys-NHε-R, wherein R is Lys, Arg, a C1-C10 straight chain or branchedalkanoyl, or cycloalkylalkanoyl;

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂;

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, and N-alkylalanine, Xaa39 is Ser or Tyr; and

Z₂ is —OH or —NH₂),

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, and Xaa26 are Ala; and    -   when Xaa1 is His, Arg, Tyr, or 4-imidazopropionyl, at least one        of Xaa3, Xaa4, and Xaa9 is Ala.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate (one) several embodiment(s) ofthe present disclosure and together with the description, serve toexplain the principles of the present disclosure.

FIG. 1A. A graph illustrating time-dependent exenatide (exendin-4)plasma levels from a single subcutaneous administration of 2 mg/kgsustained-release-Exenatide (PT302) to adult (9 weeks old) maleSprague-Dawley rats.

FIG. 1B. A graph illustrating time-dependent exenatide (exendin-4)plasma levels from a single subcutaneous administration of 2.4 mg/kg,4.8 mg/kg, or 9.6 mg/kg sustained-release-Exenatide (PT302) to adult (9weeks old) male Sprague-Dawley rats.

FIG. 2. A graph illustrating time dependent exendin-4 plasma levels froma single subcutaneous injection of sustained-release-Exenatide (PT304)at the amount of 4.0 mg/kg to adult (9 weeks old) male Sprague-Dawleyrats.

FIG. 3. A graph illustrating time-dependent exendin-4 plasma levels overa 10 week period in male Sprague-Dawley rats administered either PT302or PT304 at the amounts and times indicated.

FIG. 4A. Outline of the study design of Example 2 in whichSprague-Dawley rats were administered PT302 prior to a 6-OHDA unilaterallesion of the medial forebrain bundle.

FIG. 4B. A graph illustrating the methamphetamine-induced (meth-induced)rotational behavior of 6-OHDA rats pre-treated with PT302.

FIG. 4C. A graph illustrating plasma levels of Exendin-4 in 6-OHDA ratsthat have been pre-treated with PT302.

FIG. 5A. Outline of the study design of Example 3 in whichSprague-Dawley rats were administered PT302 after a 6-OHDA unilaterallesion of the medial forebrain bundle.

FIG. 5B. A graph illustrating the meth-induced rotational behavior of6-OHDA rats that receive post-treatment with PT302.

FIG. 5C. Representative microscopic images of Tyrosine hydroxylase (TH)immunohistochemistry of the striatum performed on rats with a 6-OHDAunilateral lesion of the medial forebrain bundle receiving vehicle(control; rats #866, #883, and #886) and PT302 (rats #881, #875, #882).Exendin-4 plasma concentrations (ng/ml) are noted for each animal.

FIG. 5D. A graph illustrating the quantified TH immunoreactivityobserved in the immunohistochemistry described in and associated withFIG. 5C.

FIG. 5E. Representative microscopic images of TH immunohistochemistry ofthe substantia nigra performed on rats with a 6-OHDA unilateral lesionof the medial forebrain bundle receiving vehicle (control; rats #866,#883, and #886) and PT302 (rats #881, #875, and #882). Exendin-4 plasmaconcentrations (ng/ml) are noted for each animal.

FIG. 5F. A graph illustrating the quantified TH immunoreactivityobserved in the immunohistochemistry described in and associated withFIG. 5E.

FIGS. 5G and 5H. Representative microscopic images of TH+ neuronsobserved on the non-lesioned side of the brain from a rat.

FIG. 51. Representative microscopic image of no TH+ neurons present insubstantia nigra on the lesioned side of the brain from a rat with a6-OHDA unilateral lesion of the medial forebrain bundle.

FIGS. 5J, 5K, and 5L. Representative images of brains of PT302 treated6-OHDA rats.

FIG. 5M. A graph illustrating the significant correlation observedbetween normalized TH immunoreactivity and Exendin-4 plasma levels inthe striatia.

FIG. 5N. A graph illustrating the significant correlation observedbetween Exendin-4 plasma levels and TH immunoreactivity in thesubstantia nigra.

FIG. 6A. Outlines the study design of Example 4.

FIG. 6B. Exendin-4 and PT302 treatment reduces rotation in rats with a6-OHDA unilateral lesion of the medial forebrain bundle.

FIG. 6C. Representative microscopy images of substantia nigra fromcontrol (Sham) rats, 6-OHDA rats, Exendin-4 treated 6-OHDA rats, andPT302 treated 6-OHDA rats.

FIG. 6D. A graph illustrating the quantified data of FIG. 6C.

FIG. 7A. Outline of the study design of Example 5.

FIG. 7B. PT302 significantly reduced rotational behavior in unilaterally6-OHDA-lesioned rats, while Exendin-4 did not reduce rotational behaviorin unilaterally 6-OHDA-lesioned rats.

FIG. 8A. Outline of the study design of Example 6.

FIG. 8B. A graph illustrating that PT302 significantly increases thetime to fall from a wire in MPTP-treated mice, while Exendin-4 did notincrease the time to fall from a wire.

FIG. 9A. Outline of the study design of Example 8.

FIG. 9B. A graph illustrating that sustained release Exenatidesignificantly increased novel object recognition in mild traumatic braininjury (mTBI) challenged mice.

FIG. 10A. A graph illustrating that Exendin-4 plasma levels aresustained for seven days post PT302 administration and, additionally,are dose-dependent.

FIG. 10B. A graph illustrating a significant difference in Exendin-4plasma levels deriving from PT302 administration was not observedbetween normal/control mice and mTBI-challenged mice.

FIG. 10C. A graph illustrating that three different doses of sustainedrelease Exenatide (PT302: 0.024, 0.12 and 0.6 mg/kg) were able toaccumulate and be time-dependently maintained in the plasma.

FIG. 11A. A graph illustrating that sustained-release Exenatide (PT302:0.024, 0.12 and 0.6 mg/kg) resulted in a high preference for new objectsin mTBI-challenged mice, as compared to untreated mTBI-challenged micethat suffered from visual memory deficits and spent less time near thenovel objects; as evaluated at 7 days following mTBI by the Novel ObjectRecognition paradigm.

FIG. 11B. A graph illustrating that sustained-release Exenatide (PT302:0.024, 0.12 and 0.6 mg/kg) ameliorated the mTBI-spatial memory deficitobserved in untreated mTBI-challenged mice as evaluated by Y-maze at 7days following mTBI.

FIG. 11C. A graph illustrating that the results of FIGS. 11A and 11B wasnot a result of anxiety-like behavior.

FIG. 12A. A graph illustrating that sustained-release Exenatide (PT302:0.12 and 0.6 mg/kg) results in a high preference for new objects inmTBI-induced mice, as compared to untreated mTBI-induced mice thatsuffered from visual memory deficits and spent less time near the novelobjects; as evaluated at 30 days following mTBI by the Novel ObjectRecognition paradigm.

FIG. 12B. A graph illustrating that sustained-release Exenatide (PT302:0.12 and 0.6 mg/kg) ameliorated the mTBI-spatial memory deficit observedin untreated mTBI-induced mice; as evaluated by Y-maze 30 days followingmTBI.

FIG. 12C. A graph illustrating that the results of FIGS. 12A and 12Bwere not a result of anxiety-like behavior.

FIG. 13A. Representative images illustrating that sustained-releaseExenatide (PT302 0.6 mg/kg) was able to prevent the decline in neuronsobserved in the cortex, CA3, and dentate gyrus of mTBI-induced mice.

FIG. 13B. A graph illustrating the quantification of the cerebral cortexdata associated with the representative images in FIG. 13A, whichdemonstrates that sustained-release Exenatide (PT302 0.6 mg/kg) was ableto prevent the decline in neurons observed in the cerebral cortex ofmTBI-induced mice.

FIG. 13C. A graph illustrating the quantification of the CA3 dataassociated with the representative images in FIG. 13A, whichdemonstrates that sustained-release Exenatide (PT302 0.6 mg/kg) was ableto prevent the decline in neurons observed in the CA3 region of thehippocampus of mTBI-induced mice.

FIG. 13D. A graph illustrating the quantification of the dentate gyrusdata associated with the representative images in FIG. 13A, whichdemonstrates that sustained-release Exenatide was able to prevent thedecline in neurons observed in the dentate gyrus region of thehippocampus of mTBI-induced mice.

FIG. 14A. Representative images of Fluoro-Jade® C staining, as a markerof neuron loss due to brain injury, in control (CTRL) andmTBI-challenged mice provided vehicle or sustained-release Exenatide at0.6 mg/kg or 0.12 mg/kg (PT302).

FIG. 14B. A graph illustrating the quantification of the hippocampal CA1region data associated with the representative images of FIG. 14A andthe strong increase in neuron loss due to traumatic brain injury in theCA1 of untreated mTBI-induced mice, which was significantly decreasedwith the administration of 0.6 mg/kg of sustained-release Exenatide(PT302).

FIG. 14C. A graph illustrating the quantification of the hippocampal CA3region data associated with the representative images of FIG. 14A andthe strong increase in neuron loss due to traumatic brain injury in theCA3 of untreated mTBI-induced mice, which was significantly decreasedwith the administration of 0.6 mg/kg or 0.12 mg/kg of sustained-releaseExenatide (PT302).

FIG. 14D. A graph illustrating the quantification of the dentate gyrusdata associated with the representative images of FIG. 14A and thestrong increase in neuron loss due to traumatic brain injury in thedentate gyrus of untreated mTBI-induced mice, which was significantlydecreased with the administration of 0.6 mg/kg or 0.12 mg/kg ofsustained-release Exenatide (PT302).

FIG. 14E. A graph illustrating the quantification of the cerebral cortexdata associated with the representative images of FIG. 14A and thestrong increase in neuron loss due to traumatic brain injury in thecortex of untreated mTBI-induced mice, which was significantly decreasedwith the administration of 0.6 mg/kg of sustained-release Exenatide(PT302).

FIG. 15A. Representative images of Ionized calcium-binding adaptormolecule 1 (IBA1) staining, as a marker of microglia activation andneuroinflammation due to traumatic brain injury, in control andmTBI-induced mice provided vehicle or sustained-release Exenatide(PT302) at 0.6 mg/kg or 0.12 mg/kg.

FIG. 15B. A graph illustrating the quantification of the CA1 dataassociated with the representative images of FIG. 15A and thatpro-inflammatory cytokine TNF-α was significantly increased in IBA1+cells in the CA1 of untreated mTBI-induced mice, which was significantlydecreased with the administration of 0.6 mg/kg or 0.12 mg/kg ofsustained-release Exenatide (PT302).

FIG. 15C. A graph illustrating the quantification of the CA3 dataassociated with the representative images of FIG. 15A and thatpro-inflammatory cytokine TNF-α was significantly increased in IBA1+cells in the CA3 of untreated mTBI-induced mice, which was significantlydecreased with the administration of 0.6 mg/kg or 0.12 mg/kg ofsustained-release Exenatide (PT302).

FIG. 15D. A graph illustrating the quantification of the dentate gyrusdata associated with the representative images of FIG. 15A and thatpro-inflammatory cytokine TNF-α was significantly increased in IBA1+cells in the dentate gyrus of untreated mTBI-induced mice, which wassignificantly decreased with the administration of 0.6 mg/kg or 0.12mg/kg of sustained-release Exenatide (PT302).

FIG. 15E. A graph illustrating the quantification of the cerebral cortexdata associated with the representative images of FIG. 15A and thatpro-inflammatory cytokine TNF-α was significantly increased in IBA1+cells in the cortex of untreated mTBI-induced mice, which wassignificantly decreased with the administration of 0.6 mg/kg or 0.12mg/kg of sustained-release Exenatide.

DETAILED DESCRIPTION

The present disclosure is based on the surprising and unexpectedenhanced delivery of the active ingredients described herein (e.g.,GLP-1, exendin and biologically active analogues or derivatives of GLP-1and exendin). The present description may be understood more readily byreference to the following detailed description of preferred embodimentsof the disclosure and the Examples included therein and to the Figuresand their previous and following description.

Before the present compounds, compositions, articles, devices, and/ormethods are disclosed and described, it is to be understood that thepresent disclosure is not limited to specific synthetic methods,specific treatment regimens, or to particular purification procedures,as such may, of course, vary. It is also to be understood that theterminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting.

All publications, patent applications, patents, and other referencesmentioned herein are incorporated by reference in their entireties,including, e.g. U.S. Pat. Nos. 8,853,160, 8,278,272, 7,576,050,9,155,702, International Patent Publication WO/2003/011892, and Gu etal. (Clinical Therapeutics. 36(1): 101-114 (2014)) are each incorporatedherein by reference in their entireties for all purposes.

As used in the specification and the appended claims, the singular forms“a,” “an” and “the” include plural referents unless the context clearlydictates otherwise. Thus, for example, reference to “a polypeptide”includes mixtures of polypeptides, reference to “a pharmaceuticalcarrier” includes mixtures of two or more such carriers, and the like.

Ranges may be expressed herein as from “about” one particular value,and/or to “about” another particular value. When such a range isexpressed, another embodiment includes from the one particular valueand/or to the other particular value. Similarly, when values areexpressed as approximations, by use of the antecedent “about,” it willbe understood that the particular value forms another embodiment. Itwill be further understood that the endpoints of each of the ranges aresignificant both in relation to the other endpoint, and independently ofthe other endpoint. As used herein, “about” refers to the givenvalue±10%.

In this specification and in the claims which follow, reference will bemade to a number of terms which shall be defined to have the followingmeanings:

“Optional” or “optionally” means that the subsequently described eventor circumstance may or may not occur, and that the description includesinstances where said event or circumstance occurs and instances where itdoes not.

As used throughout, by “subject” is meant an individual. In certainembodiments, the subject is a mammal such as a primate. In a particularembodiment, the subject is a human. Thus, the “subject” can includedomesticated animals, such as cats, dogs, etc., livestock (e.g., cattle,horses, pigs, sheep, goats, etc.), and laboratory animals (e.g., mouse,rabbit, rat, guinea pig, etc.).

The term “polypeptide” and “peptide” are generally used interchangeablyunless the context indicates otherwise. Unless indicated otherwise, both“polypeptide” and “peptide” can refer to naturally occurring ornon-naturally occurring amino acids connected by peptide bonds.

The term “steady-state” is used in its ordinary meaning withinpharmacokinetics. Briefly, a steady-state concentration, e.g., in plasmaor cerebrospinal fluid (CSF) is the concentration in the plasma and CSFwhen the rate of neuroprotective polypeptide(s) administered is equal tothe rate at which the neuroprotective polypeptide(s) are beingeliminated by the subject's body. Determining a steady-stateconcentration of the neuroprotective polypeptide(s) of the presentdisclosure is routine for one of ordinary skill in the art.

By “isolated polypeptide” or “purified polypeptide” is meant apolypeptide that is substantially free from the materials with which thepolypeptide is normally associated in nature or in culture. Thepolypeptides of the disclosure can be obtained, for example, byextraction from a natural source if available (for example, a mammaliancell), by expression of a recombinant nucleic acid encoding thepolypeptide (for example, in a cell or in a cell-free translationsystem), or by chemically synthesizing the polypeptide. In addition,polypeptide may be obtained by cleaving full length polypeptides. Whenthe polypeptide is a fragment of a larger naturally occurringpolypeptide, the isolated polypeptide is shorter than and excludes thefull-length, naturally-occurring polypeptide of which it is a fragment.

The present disclosure relates to methods of delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprises administering acontrolled-release neuroprotective formulation to the systemic bloodcirculation of the subject, wherein: the controlled-releaseneuroprotective formulation includes at least one neuroprotectivepolypeptide selected from the group consisting of GLP-1, exendin (e.g.,exendin-4), or a therapeutically effective GLP-1 or exendin analogue(such as an exendin-4 analogue); the neuroprotective polypeptide bindsto and activates a receptor that binds at least one of GLP-1, exendin(e.g., exendin-4), or a combination thereof; and the controlled-releaseneuroprotective formulation enhances the delivery of the neuroprotectivepolypeptide across a blood brain barrier (BBB) of the subject to atleast a portion of the central nervous system (CNS) relative to a rapidrelease formulation of the neuroprotective polypeptide.

As shown in FIGS. 1A, 1B, 2, and 3, the controlled-releaseneuroprotective formulation results in a greater maintenance of plasmalevels of Exenatide in an animal model. Furthermore, FIGS. 7B and 8Bdemonstrate that a controlled-release formulation of Exenatide is a moreeffective neuroprotective and a more effective neurorestorativeformulation/therapeutic than Exenatide alone.

The present disclosure relates to methods for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method can comprise: administering to thesystemic blood circulation of the subject a therapeutically effectiveamount of neuroprotective polypeptide by a controlled-releaseformulation or a device providing a sustained release or delivery of theneuroprotective polypeptide, the neuroprotective polypeptide includes atleast one neuroprotective polypeptide selected from the group consistingof GLP-1, exendin-4, or a therapeutically effective GLP-1 or exendin-4analogue, wherein the neuroprotective polypeptide binds to and activatesa receptor that binds at least one of GLP-1, exendin-4, or a combinationthereof; and wherein the controlled-release neuroprotective formulationor sustained release of the neuroprotective polypeptide enhances thedelivery and/or uptake of the neuroprotective polypeptide across ablood-brain barrier (BBB) of the subject to at least a portion of thecentral nervous system (CNS) relative to a rapid release formulation ofthe neuroprotective peptide.

The present disclosure also relates to methods of treating a subjectwith a central nervous system (CNS)-related disease or reducing at leastone symptom of a CNS-related disease in a subject in need thereof. Themethod can comprise: administering to the systemic blood circulation ofthe subject a therapeutically effective amount of a neuroprotectivepolypeptide by a controlled-release formulation or a device providing asustained release or delivery of a neuroprotective polypeptide, theneuroprotective polypeptide includes at least one neuroprotectivepolypeptide selected from the group consisting of GLP-1, exendin-4, or atherapeutically effective GLP-1 or exendin-4 analogue, theneuroprotective polypeptide binds to and activates a receptor that bindsat least one of GLP-1, exendin-4 or a combination thereof; and whereinthe controlled-release neuroprotective formulation or a device enhancesthe delivery of the neuroprotective polypeptide across a blood-brainbarrier (BBB) of the subject to at least a portion of the centralnervous system (CNS) relative to a rapid release formulation of theneuroprotective polypeptide.

In certain embodiments, the controlled-release formulation is a longacting formulation of the neuroprotective polypeptide. The long actingformulation can comprise a depot formulation for sustained release ofthe neuroprotective polypeptide. For example, the long actingformulation can comprise a composition for sustained release of theneuroprotective polypeptide (described in greater detail below). Inadditional embodiments, the controlled-release formulation furthercomprises a biodegradable polymer with a specific viscosity and coatingmaterials, having bioavailability and sustained release of theneuroprotective polypeptide in an effective concentration for a certainperiod. In additional embodiments, the controlled-release formulationfurther comprises a biodegradable polymer with a specific viscosity andcoating materials, having bioavailability and sustained release of theneuroprotective polypeptide in an effective concentration for a certainperiod without an initial burst (e.g., without an initial burst, such asa detrimental initial burst, of the active ingredient) of the activeingredient. In particular embodiments, the controlled-releaseneuroprotective formulation comprises: a controlled-release microspherethat includes a core with the neuroprotective polypeptide and abiodegradable polymer; and a coating layer that coats the core.

In an embodiment, administering the controlled-release neuroprotectiveformulation alleviates at least one symptom of at least one CNS-relatedcondition in the subject. For example, the CNS-related condition can beselected from the group consisting of Parkinson's disease (PD),traumatic brain injury (TBI), multiple sclerosis, drug addiction,alcohol addiction, neurodegenerative conditions, inflammation of abrain, Alzheimer's disease (AD), multiple system atrophy, Huntington'sdisease, chronic traumatic encephalopathy, motor neuron diseases (e.g.,amyotrophic lateral sclerosis, spinal cord injury, spinocerebellarataxia (SCA), spinal muscular atrophy (SMA)), vascular dementia,dementia with Lewy bodies (DLB), mixed dementia, frontotemporaldementia, Creutzfeldt-Jakob disease, normal pressure hydrocephalus, or acombination thereof.

Administering the controlled-release neuroprotective formulation cancomprise injecting the controlled-release neuroprotective formulation.For example, the controlled-release neuroprotective formulation may beinjected subcutaneously.

In another embodiment, administering the controlled-releaseneuroprotective formulation results in a steady-state plasmaconcentration of the neuroprotective polypeptide that is in a range ofabout 50 to about 4500 pg/mL. For example, the steady-state plasmaconcentration of the neuroprotective polypeptide can be in a range ofabout 50 to about 4500 pg/mL, about 50 to about 4250 pg/mL, about 50 toabout 4000 pg/mL, about 50 to about 3750 pg/mL, about 50 to about 3500pg/mL, about 50 to about 3250 pg/mL, about 50 to about 3000 pg/mL, about50 to about 2750 pg/mL, about 50 to about 2500 pg/mL, about 50 to about2250 pg/mL, about 50 to about 2000 pg/mL, about 50 to about 1750 pg/mL,about 50 to about 1500 pg/mL, about 50 to about 1250 pg/mL, about 50 toabout 1000 pg/mL, about 50 to about 750 pg/mL, about 50 to about 500pg/mL, about 50 to about 250 pg/mL, about 250 to about 4500 pg/mL, about250 to about 4250 pg/mL, about 250 to about 4000 pg/mL, about 250 toabout 3750 pg/mL, about 250 to about 3500 pg/mL, about 250 to about 3250pg/mL, about 250 to about 3000 pg/mL, about 250 to about 2750 pg/mL,about 250 to about 2500 pg/mL, about 250 to about 2250 pg/mL, about 250to about 2000 pg/mL, about 250 to about 1750 pg/mL, about 250 to about1500 pg/mL, about 250 to about 1250 pg/mL, about 250 to about 1000pg/mL, about 250 to about 750 pg/mL, about 250 to about 500 pg/mL, about500 to about 4500 pg/mL, about 500 to about 4250 pg/mL, about 500 toabout 4000 pg/mL, about 500 to about 3750 pg/mL, about 500 to about 3500pg/mL, about 500 to about 3250 pg/mL, about 500 to about 3000 pg/mL,about 500 to about 2750 pg/mL, about 500 to about 2500 pg/mL, about 500to about 2250 pg/mL, about 500 to about 2000 pg/mL, about 500 to about1750 pg/mL, about 500 to about 1500 pg/mL, about 500 to about 1250pg/mL, about 500 to about 1000 pg/mL, about 500 to about 750 pg/mL,about 750 to about 4500 pg/mL, about 750 to about 4250 pg/mL, about 750to about 4000 pg/mL, about 750 to about 3750 pg/mL, about 750 to about3500 pg/mL, about 750 to about 3250 pg/mL, about 750 to about 3000pg/mL, about 750 to about 2750 pg/mL, about 750 to about 2500 pg/mL,about 750 to about 2250 pg/mL, about 750 to about 2000 pg/mL, about 750to about 1750 pg/mL, about 750 to about 1500 pg/mL, about 750 to about1250 pg/mL, about 750 to about 1000 pg/mL, about 1000 to about 4500pg/mL, about 1000 to about 4250 pg/mL, about 1000 to about 4000 pg/mL,about 1000 to about 3750 pg/mL, about 1000 to about 3500 pg/mL, about1000 to about 3250 pg/mL, about 1000 to about 3000 pg/mL, about 1000 toabout 2750 pg/mL, about 1000 to about 2500 pg/mL, about 1000 to about2250 pg/mL, about 1000 to about 2000 pg/mL, about 1000 to about 1750pg/mL, about 1000 to about 1500 pg/mL, about 1000 to about 1250 pg/mL,about 1250 to about 4500 pg/mL, about 1250 to about 4250 pg/mL, about1250 to about 4000 pg/mL, about 1250 to about 3750 pg/mL, about 1250 toabout 3500 pg/mL, about 1250 to about 3250 pg/mL, about 1250 to about3000 pg/mL, about 1250 to about 2750 pg/mL, about 1250 to about 2500pg/mL, about 1250 to about 2250 pg/mL, about 1250 to about 2000 pg/mL,about 1250 to about 1750 pg/mL, about 1250 to about 1500 pg/mL, about1500 to about 4500 pg/mL, about 1500 to about 4250 pg/mL, about 1500 toabout 4000 pg/mL, about 1500 to about 3750 pg/mL, about 1500 to about3500 pg/mL, about 1500 to about 3250 pg/mL, about 1500 to about 3000pg/mL, about 1500 to about 2750 pg/mL, about 1500 to about 2500 pg/mL,about 1500 to about 2250 pg/mL, about 1500 to about 2000 pg/mL, about1500 to about 1750 pg/mL, about 1750 to about 4500 pg/mL, about 1750 toabout 4250 pg/mL, about 1750 to about 4000 pg/mL, about 1750 to about3750 pg/mL, about 1750 to about 3500 pg/mL, about 1750 to about 3250pg/mL, about 1750 to about 3000 pg/mL, about 1750 to about 2750 pg/mL,about 1750 to about 2500 pg/mL, about 1750 to about 2250 pg/mL, about1750 to about 2000 pg/mL, about 2000 to about 4500 pg/mL, about 2000 toabout 4250 pg/mL, about 2000 to about 4000 pg/mL, about 2000 to about3750 pg/mL, about 2000 to about 3500 pg/mL, about 2000 to about 3250pg/mL, about 2000 to about 3000 pg/mL, about 2000 to about 2750 pg/mL,about 2000 to about 2500 pg/mL, about 2000 to about 2250 pg/mL, about2250 to about 4500 pg/mL, about 2250 to about 4250 pg/mL, about 2250 toabout 4000 pg/mL, about 2250 to about 3750 pg/mL, about 2250 to about3500 pg/mL, about 2250 to about 3250 pg/mL, about 2250 to about 3000pg/mL, about 2250 to about 2750 pg/mL, about 2250 to about 2500 pg/mL,about 2500 to about 4500 pg/mL, about 2500 to about 4250 pg/mL, about2500 to about 4000 pg/mL, about 2500 to about 3750 pg/mL, about 2500 toabout 3500 pg/mL, about 2500 to about 3250 pg/mL, about 2500 to about3000 pg/mL, about 2500 to about 2750 pg/mL, about 2750 to about 4500pg/mL, about 2750 to about 4250 pg/mL, about 2750 to about 4000 pg/mL,about 2750 to about 3750 pg/mL, about 2750 to about 3500 pg/mL, about2750 to about 3250 pg/mL, about 2750 to about 3000 pg/mL, about 3000 toabout 4500 pg/mL, about 3000 to about 4250 pg/mL, about 3000 to about4000 pg/mL, about 3000 to about 3750 pg/mL, about 3000 to about 3500pg/mL, about 3000 to about 3250 pg/mL, about 3250 to about 4500 pg/mL,about 3250 to about 4250 pg/mL, about 3250 to about 4000 pg/mL, about3250 to about 3750 pg/mL, about 3250 to about 3500 pg/mL, about 3500 toabout 4500 pg/mL, about 3500 to about 4250 pg/mL, about 3500 to about4000 pg/mL, or about 3500 to about 3750 pg/mL.

The sustained steady-state plasma concentration of the neuroprotectivepolypeptide, as described above, results in a cumulative increase in theneuroprotective polypeptide concentration in the cerebrospinal fluid(CSF), the brain or a combination thereof in the subject. For example,the neuroprotective polypeptide concentration in the CSF can be withinthe range of about 5 to about 400 pg/mL or about 10 to about 400 pg/mL.That is, the concentration of the neuroprotective polypeptide in the CSFcan be in a range about 10 to about 350 pg/mL, about 10 to about 300pg/mL, about 10 to about 250 pg/mL, about 10 to about 200 pg/mL, about10 to about 150 pg/mL, about 10 to about 100 pg/mL, about 10 to about 50pg/mL, about 50 to about 400 pg/mL, about 50 to about 350 pg/mL, about50 to about 300 pg/mL, about 50 to about 250 pg/mL, about 50 to about200 pg/mL, about 50 to about 150 pg/mL, about 50 to about 100 pg/mL,about 100 to about 400 pg/mL, about 100 to about 350 pg/mL, about 100 toabout 300 pg/mL, about 100 to about 250 pg/mL, about 100 to about 200pg/mL, about 100 to about 150 pg/mL, about 150 to about 400 pg/mL, about150 to about 350 pg/mL, about 150 to about 300 pg/mL, about 150 to about250 pg/mL, about 150 to about 200 pg/mL, about 200 to about 400 pg/mL,about 200 to about 350 pg/mL, about 200 to about 300 pg/mL, about 200 toabout 250 pg/mL, about 250 to about 400 pg/mL, about 250 to about 350pg/mL, about 250 to about 300 pg/mL, about 300 to about 400 pg/mL, about300 to about 350 pg/mL, or about 350 to about 400 pg/mL.

In any aspect or embodiment described herein, the ratio of thesteady-state polypeptide concentration in the CFS to the plasma can bein the range of about 0.1% to about 5%. For example, the ratio of thesteady-state concentration in the CSF to the steady-state concentrationof the polypeptide in the plasma can be, in any aspect or embodimentdescribed herein, at least about 0.1%, at least about 0.3%, at leastabout 0.5%, at least about 0.7%, at least about 0.9%, at least about 1%,at least about 1.1%, at least about 1.2%, at least about 1.5%, at leastabout 2.0%, about 0.1% to about 5%, about 0.1% to about 4%, about 0.1%to about 3%, about 0.1% to about 2%, about 0.5% to about 5%, about 0.5%to about 4%, about 0.5% to about 3%, about 0.5% to about 2%, about 1% toabout 5%, about 1% to about 4%, about 1% to about 3%, about 1% to about2%, about 2% to about 5%, about 2% to about 4%, about 2% to about 3%,about 3% to about 5%, about 3% to about 4%, or about 4% to about 5%.

In any aspect or embodiment described herein, the percent change in thesteady-state level of the neuroprotective polypeptide concentration inthe plasma (i.e., percent change once steady-state is achieved) may beno greater than about 80% (e.g., no greater than about 50%). Forexample, the percent change in the neuroprotective polypeptideconcentration in the plasma may be no greater than about 80% (e.g., nogreater than about 50%) when re-administered after a steady-state plasmalevel/concentration is achieved (e.g., the neuroprotective polypeptideconcentration in the plasma may be at a steady state after about 2,about 3, about 4, about 5, or about 6 weeks of the firstadministration). For example, the percent change in the steady-stateplasma concentration of the neuroprotective polypeptide aftersteady-state is achieved is no greater than about 80%, about 79%, about78%, about 77%, about 76%, about 75%, about 74%, about 73%, about 72%,about 71%, about 70%, about 69, about 68%, about 67%, about 66%, about65%, about 64%, about 63%, about 62%, about 61%, about 60%, about 59%,about 58%, about 57%, about 56%, about 55%, about 54%, about 53%, about52%, about 51%, about 50%, about 49%, about 48%, about 47%, about 46%,about 45%, about 44%, about 43%, about 42%, about 41%, about 40%, about39%, about 39%, about 37%, about 36%, about 35%, about 34%, about 33%,about 32%, about 31%, about 30%, about 29%, about 28%, about 27%, about26%, about 25%, about 24%, about 23%, about 22%, about 21%, about 20%,about 19%, about 18%, about 17%, about 16%, about 15%, %, at 14%, about13%, about 12%, about 11%, about 10%, about 9%, about 8%, about 7%,about 6%, or about 5%, e.g. when the neuroprotective polypeptide isre-administered within about 28 days (e.g., within about 7, 14, or about21 days) of a previous neuroprotective polypeptide administration (e.g.,administered about 1, about 2, about 3, about 4, about 5, about 6, about7, about 8, about 9, about 10, about 11, about 12, about 13, about 14,about 15, about 16, about 17, about 18, about 19, about 20, about 21,about 22, about 23, about 24, about 25, about 26, about 27, or about 28days after a previous neuroprotective polypeptide(s) administration).

In any aspect or embodiment described herein, the formulation isadministered once every about 7 to about 28 days (e.g., about 7 to about21 days or about 7 days to about 14 days). For example, the formulationcan be administered a plurality, wherein each administration is about 7to about 28 days (e.g., once every about 7, about 8, about 9, about 10,about 11, about 12, about 13, about 14, about 15, about 16, about 17,about 18, about 19, about 20, about 21, about 22, about 23, about 24,about 25, about 26, about 27, or about 28 days) apart (e.g., asubsequent administration is about 7 to about 28 days after a previousadministration). The formulation can be administered, in any aspect orembodiment herein, a plurality of times, wherein the formulation isadministered at an interval of about 7 to about 28 days (e.g., about 7,about 8, about 9, about 10, about 11, about 12, about 13, about 14,about 15, about 16, about 17, about 18, about 19, about 20, or about 21day intervals (i.e., once every about 7, about 8, about 9, about 10,about 11, about 12, about 13, about 14, about 15, about 16, about 17,about 18, about 19, about 20, about 21, about 22, about 23, about 24,about 26, about 27, or about 28 day interval).

In an additional aspect, a method of treating a subject with a centralnervous system (CNS)-related disease or reducing at least one symptom ofa CNS-related disease in a subject in need thereof is provided. Themethod comprises administering to the subject a therapeuticallyeffective amount of a controlled-release neuroprotective formulation tothe systemic blood circulation of the subject, wherein: thecontrolled-release neuroprotective formulation includes at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin (e.g. exendin-4), or a therapeutically effective GLP-1 orexendin (e.g. exendin-4) analogue; the neuroprotective polypeptide bindsto and activates a receptor that binds at least one of GLP-1, exendin(e.g. exendin-4) or a combination thereof; and the controlled-releaseneuroprotective formulation enhances the delivery of the neuroprotectivepolypeptide across a blood-brain barrier (BBB) of the subject to atleast a portion of the central nervous system (CNS) relative to theneuroprotective polypeptide alone.

In a particular embodiment, administering the controlled-releaseneuroprotective formulation alleviates at least one symptom of at leastone CNS-related condition in the subject. For example, the CNS conditionis selected from the group consisting of Parkinson's disease (PD),traumatic brain injury (TBI), multiple sclerosis, drug addiction,alcohol addiction, neurodegenerative conditions, inflammation of abrain, Alzheimer's disease (AD), multiple system atrophy, Huntington'sdisease, chronic traumatic encephalopathy, motor neuron diseases (e.g.,amyotrophic lateral sclerosis, spinal cord injury, spinocerebellarataxia (SCA), spinal muscular atrophy (SMA)), vascular dementia,dementia with Lewy bodies (DLB), mixed dementia, frontotemporaldementia, Creutzfeldt-Jakob disease, normal pressure hydrocephalus, or acombination thereof.

In further embodiments, administering the controlled-releaseneuroprotective formulation comprises injecting the controlled-releaseneuroprotective formulation to the subject. For example, administeringthe controlled-release neuroprotective formulation comprisingsubcutaneously injecting the controlled-release neuroprotectiveformulation to the subject. In additional embodiments, thecontrolled-release formulation further comprises a biodegradable polymerwith a specific viscosity and coating materials, having bioavailabilityand sustained release of the neuroprotective polypeptide in an effectiveconcentration for a certain period. In any aspect or embodimentdescribed herein, the controlled-release formulation has bioavailabilityand sustained release of the neuroprotective polypeptide in an effectiveconcentration for a certain period without an initial burst (e.g. adetrimental initial burst) of the active ingredient. In particularembodiments, the controlled-release neuroprotective formulationcomprises: a controlled-release microsphere that includes a core withthe neuroprotective polypeptide and a biodegradable polymer; and acoating layer that coats the core.

In additional embodiments, administering the controlled-releaseformulation results in a steady-state plasma concentration of theneuroprotective polypeptide that is in a range as described above, e.g.about 50 to about 4500 pg/mL.

In some embodiments, administering the controlled-release formulationresults in a cumulative increase in the neuroprotective polypeptideconcentration in at least one of the cerebrospinal fluid (CSF), thebrain, or a combination thereof.

In a further aspect, the disclosure provides a method for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprises: providing a sustaineddelivery to the systemic blood circulation of the subject at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue,wherein the neuroprotective polypeptide binds to and activates areceptor that binds at least one of GLP-1, exendin-4, or a combinationthereof; and wherein the controlled-release neuroprotective formulationenhances the delivery and/or uptake of the neuroprotective polypeptideacross a blood-brain barrier (BBB) of the subject to at least a portionof the CNS relative to a rapid release formulation of theneuroprotective peptide.

In yet another aspect, the disclosure provides a method of treating asubject with a CNS-related disease or reducing at least one symptom of aCNS-related disease in a subject in need thereof. The method comprises:providing a sustained delivery to the systemic blood circulation of thesubject at least one neuroprotective polypeptide selected from the groupconsisting of GLP-1, exendin-4, or a therapeutically effective GLP-1 orexendin-4 analogue, wherein the neuroprotective polypeptide binds to andactivates a receptor that binds at least one of GLP-1, exendin-4 or acombination thereof; and wherein the controlled-release neuroprotectiveformulation enhances the delivery of the neuroprotective polypeptideacross a BBB of the subject to at least a portion of the CNS relative toa rapid release formulation of the neuroprotective polypeptide. In anyaspect or embodiment described herein, providing the sustained releaseof the neuroprotective polypeptide or polypeptides includesadministering the neuroprotective polypeptide or polypeptides with adevice (e.g., a pump, a mini-pump, an osmotic pump, an osmotic deliverydevice, an infusion pump, an intravenous administration device, aperistaltic pump, a miniature infusion pump, or the like).

The neuroprotective polypeptide or polypeptides (e.g., in thecontrolled-release neuroprotective formulation) may be administered at arate of about 0.5 pM/kg/min to about 35 pM/kg/min (e.g., about 3pM/kg/min to about 17.5 pM/kg/min). For example, the neuroprotectivepolypeptide or polypeptides may be administered at a rate of about 0.5pM/kg/min to about 35 pM/kg/min, about 0.5 pM/kg/min to about 35pM/kg/min, about 0.5 pM/kg/min to about 32.5 pM/kg/min, about 0.5pM/kg/min to about 30 pM/kg/min, about 0.5 pM/kg/min to about 27.5pM/kg/min, about 0.5 pM/kg/min to about 25 pM/kg/min, about 0.5pM/kg/min to about 22.5 pM/kg/min, about 0.5 pM/kg/min to about 20pM/kg/min, about 0.5 pM/kg/min to about 17.5 pM/kg/min, about 0.5pM/kg/min to about 15 pM/kg/min, about 0.5 pM/kg/min to about 12.5pM/kg/min, about 0.5 pM/kg/min to about 10 pM/kg/min, about 1.5pM/kg/min to about 35 pM/kg/min, about 1.5 pM/kg/min to about 35pM/kg/min, about 1.5 pM/kg/min to about 32.5 pM/kg/min, about 1.5pM/kg/min to about 30 pM/kg/min, about 1.5 pM/kg/min to about 27.5pM/kg/min, about 1.5 pM/kg/min to about 25 pM/kg/min, about 1.5pM/kg/min to about 22.5 pM/kg/min, about 1.5 pM/kg/min to about 20pM/kg/min, about 1.5 pM/kg/min to about 17.5 pM/kg/min, about 1.5pM/kg/min to about 15 pM/kg/min, about 1.5 pM/kg/min to about 12.5pM/kg/min, about 1.5 pM/kg/min to about 10 pM/kg/min, about 2.5pM/kg/min to about 35 pM/kg/min, about 2.5 pM/kg/min to about 35pM/kg/min, about 2.5 pM/kg/min to about 32.5 pM/kg/min, about 2.5pM/kg/min to about 30 pM/kg/min, about 2.5 pM/kg/min to about 27.5pM/kg/min, about 2.5 pM/kg/min to about 25 pM/kg/min, about 2.5pM/kg/min to about 22.5 pM/kg/min, about 2.5 pM/kg/min to about 20pM/kg/min, about 2.5 pM/kg/min to about 17.5 pM/kg/min, about 2.5pM/kg/min to about 15 pM/kg/min, about 2.5 pM/kg/min to about 12.5pM/kg/min, about 2.5 pM/kg/min to about 10 pM/kg/min, about 5 pM/kg/minto about 35 pM/kg/min, about 5 pM/kg/min to about 35 pM/kg/min, about 5pM/kg/min to about 32.5 pM/kg/min, about 5 pM/kg/min to about 30pM/kg/min, about 5 pM/kg/min to about 27.5 pM/kg/min, about 5 pM/kg/minto about 25 pM/kg/min, about 5 pM/kg/min to about 22.5 pM/kg/min, about5 pM/kg/min to about 20 pM/kg/min, about 5 pM/kg/min to about 17.5pM/kg/min, about 5 pM/kg/min to about 15 pM/kg/min, about 5 pM/kg/min toabout 12.5 pM/kg/min, about 5 pM/kg/min to about 10 pM/kg/min, about 10pM/kg/min to about 35 pM/kg/min, about 10 pM/kg/min to about 35pM/kg/min, about 10 pM/kg/min to about 32.5 pM/kg/min, about 10pM/kg/min to about 30 pM/kg/min, about 10 pM/kg/min to about 27.5pM/kg/min, about 10 pM/kg/min to about 25 pM/kg/min, about 10 pM/kg/minto about 22.5 pM/kg/min, about 10 pM/kg/min to about 20 pM/kg/min, about10 pM/kg/min to about 17.5 pM/kg/min, about 15 pM/kg/min to about 35pM/kg/min, about 15 pM/kg/min to about 35 pM/kg/min, about 15 pM/kg/minto about 32.5 pM/kg/min, about 15 pM/kg/min to about 30 pM/kg/min, about15 pM/kg/min to about 27.5 pM/kg/min, about 15 pM/kg/min to about 25pM/kg/min, about 20 pM/kg/min to about 35 pM/kg/min, about 20 pM/kg/minto about 35 pM/kg/min, about 20 pM/kg/min to about 32.5 pM/kg/min, about20 pM/kg/min to about 30 pM/kg/min, or about 25 pM/kg/min to about 35pM/kg/min.

In any aspect or embodiment described herein, the controlled-releaseformulation or the neuroprotective polypeptide or polypeptides may beadministered via a device. For example, the device may be an implantabledevice that contains and delivers the controlled-release formulation orthe neuroprotective polypeptide or polypeptides. The device may be apump, a mini-pump, an osmotic pump, an osmotic delivery device, aninfusion pump, an intravenous administration device, a peristaltic pump,a miniature infusion pump, or the like. In any aspect or embodimentdescribed herein, the device may be an implantable device, which mayprovide constant flow, adjustable flow, or programmable flow of thecontrolled-release formulation or the neuroprotective polypeptide orpolypeptides. For example, an osmotic delivery device as described inU.S. Pat. No. 8,298,561 B2 or U.S. Pat. No. 8,940,316 B2, both of whichare incorporated herein by reference in their entireties.

The term “osmotic delivery device” as used herein refers to a deviceused for delivery of one or more beneficial agent (e.g., theneuroprotective polypeptide or polypeptides or the controlled-releaseformulation) to a subject, wherein the device comprises, for example, areservoir (made, for example, from a titanium alloy) having a lumen thatcontains a suspension formulation (e.g., comprising the neuroprotectivepolypeptide or polypeptides or the controlled-release formulation) andan osmotic agent formulation. A piston assembly positioned in the lumenisolates the suspension formulation from the osmotic agent formulation.A semi-permeable membrane positioned at a first distal end of thereservoir adjacent the osmotic agent formulation, as well as a flowmodulator (which defines a delivery orifice through which the suspensionformulation exits the device) that is positioned at a second distal endof the reservoir adjacent the suspension formulation. The osmoticdelivery device or osmotic pump may be implanted within the subject, forexample, subcutaneously (e.g., in the inside, outside, or back of theupper arm; or in the abdominal area).

The neuroprotective polypeptide or polypeptides or thecontrolled-release formulation described herein may be administered viaa device to provide sustained delivery of the neuroprotectivepolypeptide or polypeptides or the controlled-release formulation overan extended period of time, such as over weeks, months, or up to aboutone year. Such a device, which may be an implantable device, is capableof delivering the neuroprotective polypeptide or polypeptides or thecontrolled-release formulation at a desired flow rate over a desiredperiod of time. The neuroprotective polypeptide or polypeptides or thecontrolled-release formulation may be loaded into the implantable, drugdelivery device by conventional techniques.

The neuroprotective polypeptide or polypeptides or thecontrolled-release formulation may be delivered, for example, using anosmotically, mechanically, electromechanically, or chemically drivendevice. In any aspect or embodiment described herein, theneuroprotective polypeptide or polypeptides or the controlled-releaseformulation is delivered at a flow rate that is therapeuticallyeffective to the subject in need of treatment by the neuroprotectivepolypeptide(s).

The neuroprotective polypeptide or polypeptides or thecontrolled-release formulation may be delivered over a period rangingfrom more than about one week to about one year or more (e.g., for aboutone month to about a year or more or for about three months to about ayear or more). The device may include a reservoir having at least oneorifice through which the neuroprotective polypeptide or polypeptides orthe controlled-release formulation is delivered. The neuroprotectivepolypeptide or polypeptides or the controlled-release formulation may bestored within the reservoir. In any aspect or embodiment describedherein, the device is an osmotic delivery device, which may be animplantable device, wherein delivery of the neuroprotective polypeptideor polypeptides or the controlled-release formulation is osmoticallydriven. Some osmotic delivery devices or osmotic pumps and theircomponent parts have been described, for example, the DUROS® deliverydevice or similar devices (see, e.g., U.S. Pat. Nos. 5,609,885;5,728,396; 5,985,305; 5,997,527; 6,113,938; 6,132,420; 6,156,331;6,217,906; 6,261,584; 6,270,787; 6,287,295; 6,375,978; 6,395,292;6,508,808; 6,544,252; 6,635,268; 6,682,522; 6,923,800; 6,939,556;6,976,981; 6,997,922; 7,014,636; 7,207,982; 7,112,335; 7,163,688; U.S.Patent Application Publication Nos. 2005-0175701, 2007-0281024, and2008-0091176, all of which are incorporated herein by reference in theirentireties).

The DUROS® delivery device typically consists of a cylindrical reservoirwhich contains the osmotic engine, piston, and drug formulation. Thereservoir is capped at one end by a controlled-rate water-permeablemembrane and capped at the other end by a diffusion moderator throughwhich drug formulation is released from the drug reservoir. The pistonseparates the drug formulation from the osmotic engine and utilizes aseal to prevent the water in the osmotic engine compartment fromentering the drug reservoir. The diffusion moderator is designed, inconjunction with the drug formulation (e.g., the neuroprotectivepolypeptide or polypeptides or the controlled-release formulation), toprevent body fluid from entering the drug reservoir through the orifice.

The DUROS® device releases a therapeutic agent at a predetermined ratebased on the principle of osmosis. Extracellular fluid enters the DUROS®device through a semi-permeable membrane directly into a salt enginethat expands to drive the piston at a slow and even delivery rate.Movement of the piston forces the drug formulation (e.g., theneuroprotective polypeptide or polypeptides or the controlled-releaseformulation) to be released through the orifice or exit port at apredetermined sheer rate. In any aspect or embodiment of the presentinvention, the reservoir of the DUROS® device is load with theneuroprotective polypeptide(s) or the controlled-release formulation,wherein the device is capable of delivering the neuroprotectivepolypeptide(s) or the controlled-release formulation to a subject overan extended period of time (e.g., about 1, about 2, about 3, about 4,about 5, about 6, about 7, about 8, about 9, about 10, about 11, orabout 12 months) at a predetermined, therapeutically effective deliveryrate.

Any implantable, device may be used in the practice of the presentdisclosure and may include regulator-type implantable pumps that provideconstant flow, adjustable flow, or programmable flow of the compound.

The amount of the neuroprotective polypeptide(s) or thecontrolled-release formulation employed in the delivery device of thedisclosure is that amount necessary to deliver a therapeuticallyeffective amount of the agent to achieve the desired therapeutic result.In practice, this will vary depending upon such variables, for example,as the particular agent, the site of delivery, the severity of thecondition, and the desired therapeutic effect. Typically, for an osmoticdelivery device, the volume of a beneficial agent chamber comprisingneuroprotective polypeptide(s) or the controlled-release formulation isbetween about 100 μl to about 1000 μl (e.g., about 120 μl and about 500μl or about 150 μl and about 200 μl).

In any aspect or embodiment described herein, the osmotic deliverydevice is implanted within the subject, for example, subcutaneously. Thedevice(s) can be inserted in either or both arms (e.g., in the inside,outside, or back of the upper arm) or into the abdomen. For example, thedevice may be implanted under the abdominal skin in the area extendingbelow the ribs and above the belt line. To provide a number of locationsfor insertion of one or more osmotic delivery device within the abdomen,the abdominal wall can be divided into 4 quadrants as follows: the upperright quadrant extending 5-8 centimeters below the right ribs and about5-8 centimeters to the right of the midline, the lower right quadrantextending 5-8 centimeters above the belt line and 5-8 centimeters to theright of the midline, the upper left quadrant extending 5-8 centimetersbelow the left ribs and about 5-8 centimeters to the left of themidline, and the lower left quadrant extending 5-8 centimeters above thebelt line and 5-8 centimeters to the left of the midline. This providesmultiple available locations for implantation of one or more devices onone or more occasions.

In other embodiments, administering the controlled-releaseneuroprotective formulation or providing a sustained delivery of theneuroprotective polypeptide alleviates at least one symptom of at leastone CNS-related condition in the subject selected from the groupconsisting of Parkinson's disease (PD), traumatic brain injury (TBI),multiple sclerosis, drug addiction, alcohol addiction, neurodegenerativeconditions, inflammation of a brain, Alzheimer's disease (AD), multiplesystem atrophy, Huntington's disease, chronic traumatic encephalopathy,motor neuron diseases (e.g., amyotrophic lateral sclerosis, spinal cordinjury, spinocerebellar ataxia (SCA), spinal muscular atrophy (SMA)),vascular dementia, dementia with Lewy bodies (DLB), mixed dementia,frontotemporal dementia, Creutzfeldt-Jakob disease, normal pressurehydrocephalus, or a combination thereof.

In any aspect or embodiment described herein, administering thecontrolled-release formulation or providing the sustained release of theneuroprotective polypeptide results in a steady-state plasmaconcentration of the neuroprotective polypeptide that is in a range ofabout 50 to about 4500 pg/mL.

In any aspect or embodiment described herein, administering thecontrolled-release formulation or providing the sustained release of theneuroprotective polypeptide results in a cumulative increase in theneuroprotective polypeptide concentration in at least one of thecerebrospinal fluid (CSF), the brain, or a combination thereof.

Neuroprotective Polypeptides

The neuroprotective polypeptide may have an amino acid selected from thegroup consisting of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO:4, SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7, SEQ ID NO: 8, SEQ ID NO: 9,SEQ ID NO: 10, SEQ ID NO: 11, SEQ ID NO: 12, SEQ ID NO: 13, SEQ ID NO:14, SEQ ID NO: 15, SEQ ID NO: 16, SEQ ID NO: 17, SEQ ID NO: 18, SEQ IDNO: 19, SEQ ID NO: 20, SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 23, SEQID NO: 24, SEQ ID NO: 25, SEQ ID NO: 26, SEQ ID NO: 27, SEQ ID NO: 28,SEQ ID NO: 29, SEQ ID NO: 30, SEQ ID NO: 31, SEQ ID NO: 32, SEQ ID NO:33, SEQ ID NO: 34, SEQ ID NO: 35, SEQ ID NO: 36, SEQ ID NO: 37, SEQ IDNO: 38, SEQ ID NO: 39, SEQ ID NO: 40, SEQ ID NO: 41, SEQ ID NO: 42, SEQID NO: 43, SEQ ID NO: 44, SEQ ID NO: 45, SEQ ID NO: 46, SEQ ID NO: 47,SEQ ID NO: 48, SEQ ID NO: 49, SEQ ID NO: 50, SEQ ID NO: 51, SEQ ID NO:52, SEQ ID NO: 53, SEQ ID NO: 54, or SEQ ID NO: 55. The neuroprotectivepolypeptide may comprise an amino acid sequence selected from SEQ IDNOS: 1-55. Furthermore, the neuroprotective polypeptide may consist ofan amino acid sequence selected from SEQ ID NOS: 1-55.

By “analogue of GLP-1 or exendin-4” it is meant modified GLP-1 and/orexendin amino acid sequences that show agonist properties (i.e., showone or more biological activities of GLP-1 or exendin-4). Suchmodifications include chimeric polypeptides that include one or moreamino acid residues present in GLP-1 and one or more amino acid residuespresent in exendin-4. The modifications also include truncations ofeither GLP-1 or exendin-4 or the chimeric polypeptides. For example, atruncated chimeric polypeptide is exendin-4 7-36 with the G at position36 replaced with the R in position 36 of GLP-1. The polypeptides of thepresent disclosure include one or more additional amino acids (i.e.,insertions or additions), deletions of amino acids, or substitutions inthe amino acid sequence of GLP-1 or exendin-4 without appreciable lossof functional activity as compared to GLP-1 or exendin-4. For example,the deletion can consist of amino acids that are not essential to thepresently defined differentiating activity and the substitution(s) canbe conservative (i.e., basic, hydrophilic, or hydrophobic amino acidssubstituted for the same) or non-conservative. A conservativesubstitution is one in which the substituted amino acid has similarstructural or chemical properties with the corresponding amino acid inthe reference sequence. By way of example, conservative amino acidsubstitutions involve substitution of one aliphatic or hydrophobic aminoacid, e.g. alanine, valine, leucine and isoleucine, with another;substitution of one hydroxyl-containing amino acid, e.g. serine andthreonine, with another; substitution of one acidic residue, e.g.glutamic acid or aspartic acid, with another; replacement of oneamide-containing residue, e.g. asparagine and glutamine, with another;replacement of one aromatic residue, e.g. phenylalanine and tyrosine,with another; replacement of one basic residue, e.g. lysine, arginineand histidine, with another; and replacement of one small amino acid,e.g., alanine, serine, threonine, methionine, and glycine, with another.Thus, it is understood that, where desired, modifications and changesmay be made in the amino acid sequence of GLP-1 and exendin-4, and aprotein having like characteristics still obtained. Various changes maybe made in the amino acid sequence of the GLP-1 or exendin-4 amino acidsequence (or underlying nucleic acid sequence) without appreciable lossof biological utility or activity and possibly with an increase in suchutility or activity.

The term “fragments” or “truncations” as used herein regarding GLP-1 orexendin-4 or polypeptides having amino acid sequences substantiallyhomologous thereto means a polypeptide sequence of at least 5 contiguousamino acids of either GLP-1, exendin-4, or polypeptides having aminoacid sequences substantially homologous thereto, wherein the polypeptidesequence has an insulinotropic function.

Other modifications include D-enantiomers, in which at least onenaturally occurring L-configuration of an amino acid residue is replacedby the D-configuration of the amino acid residue.

The present disclosure contemplates the use of a spacer, such as alateral spacer. The term “lateral spacer” is defined as a compound thatis incorporated within the amino acid sequence by chemical bonds,whereby the compound increases the distance between two or more aminoacid residues in order to reduce or eliminate the cleavage (e.g., by DPP1V) of the amino acid sequence at or near that position. For example, inthe sequence A-X-B, where A and B are amino acid residues and X is thelateral spacer, cleavage of the sequence by an enzyme is reduced oreliminated when compared to the sequence in the absence of the lateralspacer (A-B). For example, 1 to 4 compounds can be incorporated into theamino acid sequence as the lateral spacer. Thus, 1, 2, 3, or 4 compoundsare inserted in various embodiments.

In general, the lateral spacer is any compound that can form a peptidebond with an amino acid, i.e., contains at least one amino group and atleast one carboxyl group (CO₂), where the carboxyl group can be acarboxylic acid or the ester or salt thereof. In one embodiment, thelateral spacer has the formula H₂N—R¹—CO₂H (I), wherein R¹ comprises asubstituted or unsubstituted, branched or straight chain C₁ to C₂₀ alkylgroup, alkenyl group, or alkynyl group; a substituted or unsubstitutedC₃ to C₈ cycloalkyl group; a substituted or unsubstituted C₆ to C₂₀ arylgroup; or substituted or unsubstituted C₄ to C₂₀ heteroaryl group. Inanother embodiment, R¹ can be represented by the formula (CH₂)_(n),where n is from 1 to 10. In an embodiment, R¹ is (CH₂)₃(3-aminopropionicacid) or (CH₂)₅(6-aminohexanoic acid).

The present disclosure provides a method that includes theadministration of a controlled-release formulation comprising at leastone neuroprotective polypeptide. The polypeptide can comprise a modifiedGLP-1 or exendin (e.g. exendin-4) sequence, or an analogue or derivativethereof, with a spacer between the amino acid residues comparable toresidues 7 and 8 (designated in the case of GLP-1 with a Aha spacer, forexample, “GLP-1 Aha⁸”) or residues 8 and 9 (designated in the case ofGLP-1 with a Aha spacer, for example, “GLP-1Aha⁹”) of GLP-1. The lateralspacer, in one embodiment, is one or more aminoproprionic acid residues.In one embodiment, the spacer is a 6-aminohexanoic acid spacer and the6-aminohexanoic acid spacer comprises less than four 6-aminohexanoicacid residues. The polypeptide, for example, can comprise GLP-1 7-36with one or more 6-aminohexanoic acid residues between residues 7 and 8(i.e., GLP-1 Aha⁸) or can comprise GLP-1 7-36 with one or more6-aminohexanoic acid residues between residues 8 and 9. The polypeptidecan comprise GLP-1 7-36 with two or more 6-aminohexanoic acid residuesbetween residues 7 and 8 (i.e., GLP-1 Aha⁸) or can comprise GLP-1 7-36with two or more 6-aminohexanoic acid residues between residues 8 and 9.The polypeptide, for example, can comprise GLP-1 7-36 with three or more6-aminohexanoic acid residues between residues 7 and 8 (i.e., GLP-1Aha⁸) or can comprise GLP-1 7-36 with three or more 6-aminohexanoic acidresidues between residues 8 and 9.

In other embodiments, the polypeptide of the present disclosure has aninsulinotropic effect that is comparable to the effect of an equimolaramount of GLP-1 or, in an embodiment, an insulinotropic effect that iscomparable to the effect of an equimolar amount of exendin-4. By“comparable to the effect” it is meant an effect that is within about10-15% of the effect of GLP-1 or exendin-4. In another embodiment, thepolypeptide has an insulinotropic effect that exceeds the insulinotropiceffect of either GLP-1 or exendin-4. By “exceeding the effect” of GLP-1or exendin-4 it is meant an increase in insulinotropic effect comparedto GLP-1 or exendin-4, such as an increase that is greater than about10% of the effect of GLP-1 or exendin-4. Thus, in an embodiment, thepolypeptide of the present disclosure is as potent as GLP-1 orexendin-4, and in another embodiment, the polypeptide of the presentdisclosure is more potent that GLP-1 and, optionally, more potent thanexendin-4. In other embodiments, the polypeptide of the presentdisclosure is longer acting than GLP-1. In a further embodiment, thepolypeptide is at least as long acting as exendin-4. In otherembodiments, the polypeptide is longer acting than exendin-4. By “longeracting” it is meant that the polypeptide is more resistant than GLP-1 orexendin-4 to at least one degradative enzyme. For example, thepolypeptide of the present disclosure is more resistant to degradationby the enzyme dipeptidyl peptidase-4 (DPPIV) than is GLP-1 and,optionally, more resistant than exendin-4. Such resistance to one ormore degradative enzymes can be assessed directly by detecting theamount of degradation products (e.g., the amount of N-terminaldegradation products) or the amount of uncleaved polypeptide.Alternatively, the resistance to one or more degradative enzymes can bedetected indirectly by assessing the reduction in insulinotropic effectover time following administration of a polypeptide of the disclosure.For example, as the degradative enzymes cleave the polypeptides of thedisclosure, plasma insulin levels should decline after a singleadministration. In additional embodiments, this decline would be slowerthan for GLP-1 and/or perhaps even slower than for exendin-4.

The polypeptides of the disclosure can be prepared using any of a numberof chemical polypeptide synthesis techniques well known to those ofordinary skill in the art including solution methods and solid phasemethods. Solid phase synthesis in which the C-terminal amino acid of thepolypeptide sequence is attached to an insoluble support followed bysequential addition of the remaining amino acids in the sequence is onesynthetic method for preparing the polypeptides. Techniques for solidphase synthesis are described by Merrifield et al., J. Am. Chem. Soc.85:2149-2156 (1963). Many automated systems for performing solid phasepeptide synthesis are commercially available.

Solid phase synthesis is started from the carboxy-terminal end (i.e.,the C-terminus) of the polypeptide by coupling a protected amino acidvia its carboxyl group to a suitable solid support. The solid supportused is not a critical feature provided that it is capable of binding tothe carboxyl group while remaining substantially inert to the reagentsutilized in the peptide synthesis procedure. For example, a startingmaterial can be prepared by attaching an amino-protected amino acid viaa benzyl ester linkage to a chloromethylated resin or a hydroxymethylresin or via an amide bond to a benzhydrylamine (BHA) resin orp-methylbenzhydrylamine (MBHA) resin. Materials suitable for use assolid supports are well known to those of skill in the art and include,but are not limited to, the following: halomethyl resins, such aschloromethyl resin or bromomethyl resin; hydroxymethyl resins; phenolresins, such as 4-(a-[2,4-dimethoxyphenyl]-Fmoc-aminomethyl)phenoxyresin; tert-alkyloxycarbonyl-hydrazidated resins; and the like. Suchresins are commercially available and their methods of preparation areknown to those of ordinary skill in the art.

The acid form of the peptides may be prepared by the solid phase peptidesynthesis procedure using a benzyl ester resin as a solid support. Thecorresponding amides may be produced by using benzhydrylamine ormethylbenzhydrylamine resin as the solid support. Those skilled in theart will recognize that when the BHA or MBHA resin is used, treatmentwith anhydrous hydrofluoric acid to cleave the peptide from the solidsupport produces a peptide having a terminal amide group.

The α-amino group of each amino acid used in the synthesis should beprotected during the coupling reaction to prevent side reactionsinvolving the reactive α-amino function. Certain amino acids alsocontain reactive side-chain functional groups (e.g. sulfhydryl, amino,carboxyl, hydroxyl, etc.) which must also be protected with appropriateprotecting groups to prevent chemical reactions from occurring at thosesites during the peptide synthesis. Protecting groups are well known tothose of skill in the art. See, for example, The Peptides: Analysis,Synthesis, Biology, Vol. 3: Protection of Functional Groups in PeptideSynthesis (Gross and Meienhofer (eds.), Academic Press, N.Y. (1981)).

A properly selected α-amino protecting group will render the α-aminofunction inert during the coupling reaction, will be readily removableafter coupling under conditions that will not remove side chainprotecting groups, will not alter the structure of the peptide fragment,and will prevent racemization upon activation immediately prior tocoupling. Similarly, side-chain protecting groups must be chosen torender the side chain functional group inert during the synthesis, mustbe stable under the conditions used to remove the α-amino protectinggroup, and must be removable after completion of the peptide synthesisunder conditions that will not alter the structure of the peptide.

Coupling of the amino acids may be accomplished by a variety oftechnique known to those of skill in the art. Typical approaches involveeither the conversion of the amino acid to a derivative that will renderthe carboxyl group more susceptible to reaction with the free N-terminalamino group of the peptide fragment, or use of a suitable coupling agentsuch as, for example, N,N′-dicyclohexylcarbodimide (DCC) orN,N′-diisopropylcarbodiimide (DIPCDI). Frequently, hydroxybenzotriazole(HOBt) is employed as a catalyst in these coupling reactions.

Generally, synthesis of the peptide is commenced by first coupling theC-terminal amino acid, which is protected at the N-amino position by aprotecting group such as fluorenylmethyloxycarbonyl (Fmoc), to a solidsupport. Prior to coupling of Fmoc-Asn, the Fmoc residue has to beremoved from the polymer. Fmoc-Asn can, for example, be coupled to the4-(a-[2,4-dimethoxyphenyl]-Fmoc-amino-methyl)phenoxy resin usingN,N′-dicyclohexylcarbodimide (DCC) and hydroxybenzotriazole (HOBt) atabout 25° C. for about two hours with stirring. Following the couplingof the Fmoc-protected amino acid to the resin support, the α-aminoprotecting group is removed using 20% piperidine in DMF at roomtemperature.

After removal of the α-amino protecting group, the remainingFmoc-protected amino acids are coupled stepwise in the desired order.Appropriately protected amino acids are commercially available from anumber of suppliers (e.g., Novartis (Switzerland) or Bachem (Torrance,Calif.)). As an alternative to the stepwise addition of individual aminoacids, appropriately protected peptide fragments consisting of more thanone amino acid may also be coupled to the “growing” peptide. Selectionof an appropriate coupling reagent, as explained above, is well known tothose of skill in the art.

Each protected amino acid or amino acid sequence is introduced into thesolid phase reactor in excess and the coupling is carried out in amedium of dimethylformamide (DMF), methylene chloride (CH₂Cl₂), ormixtures thereof. If coupling is incomplete, the coupling reaction maybe repeated before deprotection of the N-amino group and addition of thenext amino acid. Coupling efficiency may be monitored by a number ofmeans well known to those of skill in the art. A method of monitoringcoupling efficiency may be by the ninhydrin reaction. Peptide synthesisreactions may be performed automatically using a number of commerciallyavailable peptide synthesizers such as the Biosearch 9500™ synthesizer(Biosearch, San Raphael, Calif.).

The peptide can be cleaved and the protecting groups removed by stirringthe insoluble carrier or solid support in anhydrous, liquid hydrogenfluoride (HF) in the presence of anisole and dimethylsulfide at about 0°C. for about 20 to 90 minutes, e.g. 60 minutes; by bubbling hydrogenbromide (HBr) continuously through a 1 mg/10 mL suspension of the resinin trifluoroacetic acid (TFA) for 60 to 360 minutes at about roomtemperature, depending on the protecting groups selected; or byincubating the solid support inside the reaction column used for thesolid phase synthesis with 90% trifluoroacetic acid, 5% water and 5%triethylsilane for about 30 to 60 minutes. Other deprotection methodswell known to those of skill in the art may also be used.

The peptides can be isolated and purified from the reaction mixture bymeans of peptide purification well known to those of skill in the art.For example, the peptides may be purified using known chromatographicprocedures such as reverse phase HPLC, gel permeation, ion exchange,size exclusion, affinity, partition, or countercurrent distribution.

The neuroprotective polypeptides can also be prepared by other meansincluding, for example, recombinant techniques. Examples of appropriatecloning and sequencing techniques, and instructions sufficient to directpersons of skill through many cloning exercises are found in Sambrook etal. (1989) Molecular Cloning—A Laboratory Manual (2nd ed.) Vol. 1-3,Cold Spring Harbor Laboratory, Cold Spring Harbor Press, NY, (Sambrook).

For example, the exendin derivative or derivatives utilized in thecontrolled-release formulation may be a compound represented by ChemicalFormula I, or its pharmaceutically acceptable salt:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 Xaa27 Xaa28-Z₁,   (Chemical Formula I)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala, or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, or a C1-C10straight chain or branched alkanoyl;

Xaa22 is Ala, Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

Xaa27 is Ala or Lys;

Xaa28 is Ala or Asn; and

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂,

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, or N-alkylalanine, Xaa39 is Ser, or Tyr (e.g.Ser), and

Z₂ is —OH, or —NH₂,

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, Xaa26, Xaa27, and Xaa28 are Ala; and    -   when Xaa1 is His, Arg, or Tyr, at least one of Xaa3, Xaa4, and        Xaa9 is Ala.

In some embodiments, the N-alkyl groups for N-alkylglycine,N-alkylpentylglycine, and N-alkylalanine may include lower alkyl groups,such as, of 1 to about 6 carbon atoms or 1 to 4 carbon atoms. Thecompound represented by Chemical Formula I may include compoundsidentified in Examples 1 to 89 (Compounds 1 to 89, respectively), andthe corresponding compounds identified in Examples 104 and 105 in PCTApplication Serial No. PCT/US98/24273, filed on Nov. 13, 1998, entitled“Novel Exendin Agonist Compounds”, which is hereby incorporated byreference in its entireties for all purposes.

In a particular embodiment, exendin derivatives of Chemical Formula Imay include those wherein Xaa1 of Chemical Formula I is His, Ala,Norval, or 4-imidazopropionyl. In another embodiment, Xaa1 of ChemicalFormula I is His, Ala, or 4-imidazopropionyl. In an additionalembodiment, the Xaa1 of Chemical Formula I is His or 4-imidazopropionyl.

Exendin derivatives of Chemical formula I may be those wherein Xaa2 isGly.

Exendin derivatives of Chemical Formula I may be those wherein Xaa3 isAla.

Exendin derivatives of Chemical Formula I may be those wherein Xaa4 isAla.

Exendin derivatives of Chemical Formula I may be those wherein Xaa9 isAla.

Exendin derivatives of Chemical Formula I may be those wherein Xaa14 isLeu, pentylglycine, or Met.

Exendin derivatives of Chemical Formula I may be those wherein Xaa21 isLys-NHε-R, wherein R is Lys, Arg, or C₁-C₁₀ straight chain or branchedalkanoyl.

In an embodiment, the exendin derivatives of Chemical Formula I may bethose wherein Xaa25 is Trp or Phe.

In another embodiment, the exendin derivatives of Chemical Formula I maybe those wherein Xaa6 is Ala, Phe, or naphthylalanine, Xaa22 is Phe ornaphthylalanine, and Xaa23 is Ile or Val. Further, exendin derivativesof Chemical Formula I may be those wherein:

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, thioproline, and N-alkylalanine; Z₁ maybe —NH₂; and Z₂ may be —NH₂.

In other embodiments, the exendin derivatives of Chemical Formula I maybe those wherein Xaa1 is Ala, His, or Tyr (e.g., Ala or His); Xaa2 isAla or Gly; Xaa6 is Phe or naphthylalanine; Xaa14 is Ala, Leu,pentylglycine, or Met; Xaa22 is Phe or naphthylalanine;

Xaa23 is Ile or Val; Xaa31, Xaa36, Xaa37, and Xaa38 are independentlyselected from the group consisting of Pro, homoproline, thioproline, andN-alkylalanine; Xaa39 is Ser or Tyr (e.g. Ser); and Z₁ may be —NH₂.

According to an embodiment, the exendin derivatives of Chemical FormulaI may be those wherein Xaa1 is His or Ala; Xaa2 is Gly or Ala; Xaa3 isAla, Asp, or Glu; Xaa4 is Ala or Gly; Xaa5 is Ala or Thr; Xaa6 is Phe ornaphthylalanine; Xaa7 is Thr or Ser; Xaa8 is Ala, Ser, or Thr; Xaa9 isAla, Asp, or Glu; Xaa10 is Ala, Leu, or pentylglycine; Xaa11 is Ala orSer;

Xaa12 is Ala or Lys; Xaa13 is Ala or Gln; Xaa14 is Ala, Leu, Met, orpentylglycine; Xaa15 is Ala or Glu; Xaa16 is Ala or Glu; Xaa17 is Ala orGlu; Xaa19 is Ala or Val; Xaa20 is Ala or Arg; Xaa21 is Ala or Leu;Xaa22 is Phe or naphthylalanine; Xaa23 is Ile, Val, ortert-butylglycine; Xaa24 is Ala, Glu, or Asp; Xaa25 is Ala, Trp, or Phe;Xaa26 is Ala or Leu;

Xaa27 is Ala or Lys; Xaa28 is Ala or Asn; Z₁ is —OH, —NH2, Gly-Z₂, GlyGly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31 Ser-Z₂, Gly Gly Xaa31 SerSer-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala-Z₂,Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38-Z₂, orGly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38 Xaa39-Z₂; Xaa31, Xaa36,Xaa37, and Xaa38 are independently Pro, homoproline, thioproline, orN-methylalanine; Xaa39 is Ser or Tyr (e.g. Ser); and Z₂ is —OH or —NH₂,provided that no more than three of Xaa3, Xaa5, Xaa6, Xaa8, Xaa10,Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20, Xaa21,Xaa24, Xaa25, Xaa26, Xaa27, and Xaa28 are Ala, and when Xaa1 is His,Arg, or Tyr, at least one of Xaa3, Xaa4, and Xaa9 may be Ala.

In further embodiments, the compounds of Chemical Formula I may includethose having the amino acid sequences of SEQ ID NOS: 5 to 93 set forthin PCT application Serial No. PCT/US98/25728, or those set forth in U.S.Provisional Application 60/066,029, which are hereby incorporated byreference.

According to an embodiment, provided are compounds where Xaa14 is Leu,He, Val, or pentylglycine (e.g. Leu or pentylglycine); and Xaa25 is Ala,Phe, Tyr, or naphthylalanine (e.g. Phe or naphthylalanine). Thesecompounds will be less susceptible to oxidative degradation, both invitro and in vivo, as well as during synthesis of the compound.

In another aspect, the exendin derivatives may include the compoundsrepresented by Chemical Formula II, or their pharmaceutically acceptablesalts:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 X₁-Z₁,   (Chemical Formula II)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R (wherein, R is Lys, Arg, C1-C10 straightchain or branched alkanoyl, or cycloalleyl-alkanoyl);

Xaa22 is Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

X₁ is Lys Asn, Asn Lys, Lys-NHε-R Asn, Asn Lys-NHε-R, Lys-NHε-R Ala, AlaLys-NHε-R, wherein R is Lys, Arg, a C1-C10 straight chain or branchedalkanoyl, or cycloalkylalkanoyl;

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂;

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, and N-alkylalanine, Xaa39 is Ser or Tyr; and

Z₂ is —OH or —NH₂),

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, and Xaa26 are Ala; and    -   when Xaa1 is His, Arg, Tyr, or 4-imidazopropionyl, at least one        of Xaa3, Xaa4, and Xaa9 is Ala.

In certain embodiments, exendin derivatives of Chemical Formula II mayinclude those wherein Xaa1 is His, Ala, Norval, or 4-imidazopropionyl(e.g. Xaa1 includes His, 4-imidazopropionyl, or Ala, or Xaa1 includesHis, or 4-imidazopropionyl).

Exendin derivatives of Chemical Formula II may be those wherein Xaa2 isGly.

Exendin derivatives of Chemical Formula II may be those wherein Xaa4 isAla.

Exendin derivatives of Chemical Formula II may be those wherein Xaa9 isAla.

Exendin derivatives of Chemical Formula II may be those wherein Xaa14 isLeu, pentylglycine, or Met.

Exendin derivatives of Chemical Formula II may be those wherein Xaa25 isTrp or Phe.

Exendin derivatives of Chemical Formula II may be those wherein Xaa6 isAla, Phe, or naphthylalanine, Xaa22 is Phe or naphthylalanine, and Xaa23is Ile or Val.

Exendin derivatives of Chemical Formula II may be those wherein Z₁ is—NH₂.

Exendin derivatives of Chemical Formula II may be those wherein Xaa31,Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, thioproline, and N-alkylalanine.

Exendin derivatives of Chemical Formula II may be those wherein Xaa39 isSer or Tyr (e.g. Ser). Eexendin derivatives of Chemical Formula II maybe those wherein Z2 is —NH₂.

Exendin derivatives of Chemical Formula II may be those wherein Z₁ is—NH₂.

Exendin derivatives of Chemical Formula II may be those wherein Xaa21 isLys-NHε-R, wherein, R is Lys, Arg, or C1-C10 straight chain or branchedalkanoyl.

Exendin derivatives of Chemical Formula II may be those wherein X1 isLys Asn, Lys-NHε-R Asn, or Lys-NHε-R Ala, wherein R is Lys, Arg, or aC1-C10 straight chain or branched alkanoyl.

In further embodiments, exendin derivatives of Chemical Formula II mayinclude compounds having the amino acid sequences identified as SEQ IDNos: 95-110 set forth in WO99/025728. The exendin derivatives ofChemical Formula II may include compounds having the amino acidsequences identified as SEQ ID Nos: 5-93, as described in PCTapplication PCT/US98/24210, filed Nov. 13, 1998, entitled “Novel ExendinAgonist Compounds”. In another aspect, the exendin derivatives ofChemical Formula II may include compounds having the amino acidsequences identified as SEQ ID Nos: 37-40 set forth in WO99/007404. Theabove documents are hereby incorporated by reference.

The abbreviations used in Chemical Formula I and II stand for thefollowing.

“ACN” and “CH₃CN” refer to acetonitrile.

“Boc”, “tBoc”, and “Tboc” refer to t-butoxy carbonyl.

“DCC” refers to N,N′-dicyclohexylcarbodiimide.

“Fmoc” refers to fluorenylmethoxycarbonyl.

“HBTU” refers to 2-(1H-benzotriazol-1-yl)-1,1,3,3,-tetramethyluroniumhexafluorophosphate.

“HOBt” refers to 1-hydroxybenzotriazole monohydrate.

“homoP” and “hPro” refer to homoproline.

“MeAla” and “Nme” refer to N-methylalanine.

“naph” refers to naphthylalanine.

“pG” and “pGly” refer to pentylglycine.

“tBuG” refers to tertiary-butylglycine.

“ThioP” and “tPro” refer to thioproline.

“3Hyp” refers to 3-hydroxyproline.

“4Hyp” refers to 4-hydroxyproline.

“NAG” refers to N-alkylglycine.

“NAPG” refers to N-alkylpentylglycine.

“Norval” refers to norvaline.

In an embodiment, the exendin fragments or derivatives may have aC-terminus substituted or non-substituted with an amide group, and maybe selected from the group consisting of exendin-4(1-28) (SEQ ID NO:15), exendin-4(1-28) amide, exendin-4(1-30) (SEQ ID NO: 7),exendin-4(1-30) amide, exendin-4(1-31) (SEQ ID NO: 54), exendin-4(1-31)amide, ¹⁴Leu25Phe exendin-4 (SEQ ID NO: 55), ¹⁴Leu²⁵Phe exendin-4 amide,and their pharmaceutically acceptable salts.

Controlled-Release Formulation

According to other embodiments, the controlled-release composition ormicrospheres may contain exendin, GLP-1 or a therapeutically effectiveGLP-1 or exendin analogue as an active ingredient in the amount of about0.1 to about 10 parts by weight (e.g. about 0.8 to about 6 parts byweight) based on 100 parts by weight of the composition or microspherecomprising: exendin (such as exendin-4), GLP-1 or a therapeuticallyeffective GLP-1 or exendin analogue (such as an exendin-4 analogue);biodegradable polymers; and coating materials. For example, thecontrolled-release composition or microspheres may include about 0.1 toabout 10 parts, about 0.1 to about 9 parts, about 0.1 to about 8 parts,about 0.1 to about 7 parts, about 0.1 to about 6 parts, about 0.1 toabout 6 parts, about 0.1 to about 5 parts, about 0.1 to about 4 parts,about 0.1 to about 3 parts, about 0.5 to about 10 parts, about 0.5 toabout 9 parts, about 0.5 to about 8 parts, about 0.5 to about 7 parts,about 0.5 to about 6 parts, about 0.5 to about 6 parts, about 0.5 toabout 5 parts, about 0.5 to about 4 parts, about 0.5 to about 3 parts,about 1 to about 10 parts, about 1 to about 9 parts, about 1 to about 8parts, about 1 to about 7 parts, about 1 to about 6 parts, about 1 toabout 6 parts, about 1 to about 5 parts, about 1 to about 4 parts, about1 to about 3 parts, about 2 to about 10 parts, about 2 to about 9 parts,about 2 to about 8 parts, about 2 to about 7 parts, about 2 to about 6parts, about 2 to about 6 parts, about 2 to about 5 parts, about 2 toabout 4 parts, about 3 to about 10 parts, about 3 to about 9 parts,about 3 to about 8 parts, about 3 to about 7 parts, about 3 to about 6parts, about 4 to about 10 parts, about 4 to about 9 parts, about 4 toabout 8 parts, about 4 to about 7 parts, about 5 to about 10 parts,about 5 to about 9 parts, about 5 to about 8 parts, about 6 to about 10parts, about 6 to about 9 parts, or about 7 to about 10 parts of exendinor a therapeutically effective analogue thereof and/or GLP-1 or atherapeutically effective analogue thereof by weight, based on 100 partsby weight of the composition or microsphere comprising: exendin, GLP-1,or a therapeutically effective GLP-1 or exendin analogue; biodegradablepolymers; and coating materials. When the amount of exendin, GLP-1 or atherapeutically effective GLP-1 or exendin analogue contained in thecomposition or microspheres according to the present disclosure is lowerthan the above range, the efficient effect of exendin, GLP-1 or atherapeutically effective GLP-1 or exendin analogue cannot be obtained,and when the amount of exendin, GLP-1 or a therapeutically effectiveGLP-1 or exendin analogue is higher than the above range, the initialburst of exendin, GLP-1 or a therapeutically effective GLP-1 or exendinanalogue is increased, thereby causing side effects due to an initialburst, and thus it is preferable that the amount of exendin, GLP-1 or atherapeutically effective GLP-1 or exendin analogue is within the aboverange.

The biodegradable polymer refers to all polymers that do not harm humanbeings, because when it is administered into the body, it can be slowlydegraded and excreted. The biodegradable polymer may include one or more(e.g., one, two, three, four, five, six, or more) selected from thegroup consisting of polylactide (PLA), polyglycolide (PGA),poly(lactide-co-glycolide) (PLGA), polyorthoester, polyanhydride,polyhydroxybutyric acid, polycaprolactone, and polyalkylcarbonate, andcopolymers of one or more polymers and polyethylenglycol (PEG), whereinthe one or more polymers may be in the form of a copolymer or a simplemixture.

For example, the biodegradable polymer may be one or more selected fromthe group consisting of poly(lactide-co-glycolide)s (PLGA) consisting ofRG502H (IV=0.16 to 0.24 dL/g), RG503H (IV=0.32 to 0.44 dL/g), and RG504H(IV=0.45 to 0.60 dL/g), having the lactide:glycolide ratio of 1:1, andRG752H (IV=0.14 to 0.22 dL/g) having the lactide:glycolide ratio of75:25, polylactides (PLA), R202H (IV=0.16 to 0.24 dL/g) and R203H(IV=0.25 to 0.35 dL/g), which are provided by Evnik, Germany;poly(lactide-co-glycolide)s, 5050DL 2A (IV=0.15 to 0.25 dL/g), 5050DL 3A(IV=0.25 to 0.43 dL/g), and 5050DL 4A (IV=0.38 to 0.48 dL/g), which arecopolymers provided by Evonik (Parsippany, N.J.), USA, having alactide:glycolide ratio of 1:1; and the like, but equivalent polymersmay be provided/acquired from any appropriate source.

In further embodiments, the biodegradable polymer may be a polymer-sugarcomplex, wherein a sugar is coupled with: (1) a polymer selected fromthe group consisting of polylactides (PLA), polyglycolides (PGA),poly(lactide-co-glycolide)s (PLGA), polyorthoesters, polyanhydrides,polyhydroxybutyric acids, polycaprolactones, and polyalkylcarbonates;(2) a copolymer of at least two of the polymer group; or (3) a copolymerof polyethylenglycol (PEG) and one of the polymer group.

In other embodiment of the present disclosure, the polymer-sugar complexmay refer to a complex, wherein the polymer is substituted for ahydroxyl group of the sugar. The sugar may include monosaccharides andpolysaccharides, which include 1 to 8 saccharide units, wherein eachsaccharide unit includes 3 to 6 hydroxyl groups, and straight chainsugar-alcohols including 3 to 6 hydroxyl groups and having a molecularweight of 20,000 or less. The sugar-alcohols may include mannitol,pentaerythritol, sorbitol, ribitol, and xylitol. The polymer coupleswith the sugar at three or more hydroxyl groups present in the sugar.

The polymer-sugar complex according to the above embodiment has in vivoproperties similar to the polymer that is coupled with sugar, hasvarious degradation rates depending on the kind of the polymer used, andis degraded to a harmless polymer and sugar in the body, and thereforeit may be suitable for the biodegradable polymer. In an embodiment, thepolymer-sugar complex may be a PLA-glucose complex, a PGA-glucosecomplex, or a PLGA-glucose complex, wherein the PLGA-glucose complex maybe one having the following structure:

In the controlled-release microspheres according to the presentdisclosure, the coating layer formed on the surface thereof allowseffective control of the initial burst of exendin or GLP-1 ortherapeutically effective GLP-1 or exendin analogue, thereby preventingthe side effects caused by the excessive initial burst. Thebiodegradable polymer may be used without any limitation of viscosity.

In the controlled-release composition/formulation according to thepresent disclosure, the biodegradable polymer plays a role as a matrixfor preserving the active ingredient (exendin, GLP-1 or atherapeutically effective GLP-1 or exendin analogue), where aninsufficiently low viscosity of the polymer fails to effectivelypreserve the active ingredient, thereby increasing the initial burst,and an excessively high viscosity of the polymer causes a decrease inthe total released amount of the active ingredient, thereby decreasingthe bioavailability thereof. In the present disclosure, not only thebiodegradable polymer, but also, the coating materials contained in thecomposition plays a role of controlling drug release, and thus, thebiodegradable polymer having a relatively low viscosity can be used.Therefore, in order to effectively control the initial burst of drug andimprove the bioavailability, the intrinsic viscosity (IV) of thebiodegradable polymer, which is measured for a biodegradable polymerdissolved in chloroform at a concentration of 1% (W/V) at 25° C.±0.1° C.using a Ubbelohde Viscometer, may be about 0.1 to about 0.6 dL/g (e.g.about 0.15 to about 0.31 dL/g or about 0.16 to about 0.24 dL/g).

In the composition, formulation or the microspheres of the presentdisclosure, the biodegradable polymer plays a role as a matrix forpreserving the active ingredient during release and controlling therelease rate, where its content in the composition or the microspheresmay be about 85 to about 99.89 parts by weight (e.g. about 91 to about99 parts by weight), based on 100 parts by weight of thecomposition/formulation or the microspheres containing the activeingredient (exendin, GLP-1 or a therapeutically effective GLP-1 orexendin analogue), biodegradable polymer(s), and coating material(s).

The coating material is used to prevent excessive initial burst andincreasing the bioavailability of the active ingredient, and in themicrospheres of the present disclosure, it may be in the form of acoating layer on the surface thereof. The coating material may be one ormore (e.g. one, two, or three) selected from basic amino acids,polypeptides, and organic nitrogen compounds. The basic amino acid mayinclude arginine, lysine, histidine, and their derivatives. Thepolypeptide may include 2 to 10 amino acids (e.g. 2 to 5 amino acids),including one or more (e.g., one, two or three) selected from arginine,lysine, and histidine. The polypeptide may include more basic aminoacids than acidic amino acids, thereby exhibiting a basic property. Forexample, the polypeptide may be L-Ala-L-His-L-Lys, L-Arg-L-Phe,Gly-L-His, Gly-L-His-Gly, Gly-L-His-L-Lys, L-His-Gly, L-His-Leu,L-Lys-L-Tyr-L-Lys, L-His-L-Val, L-Lys-L-Lys, L-Lys-L-Lys-L-Lys,L-Lys-L-Thr-L-Thr-L-Lys-L-Ser, and the like. Further, the organicnitrogen compound may be creatine, creatinine, urea, and the like.

The content of the coating material contained in the composition of thepresent disclosure, or coated on the microspheres, may be about 0.01 toabout 5 parts by weight (e.g. about 0.015 to about 3 parts, about 0.01to about 4, about 0.01 to about 3, about 0.01 to about 2, about 0.01 toabout 4, about 0.01 to about 2, about 0.015 to about 5, about 0.015 toabout 4, about 0.015 to about 2, about 0.05 to about 5, about 0.05 toabout 4, about 0.05 to about 3, about 0.05 to about 2, about 0.1 toabout 5, about 0.1 to about 4, about 0.1 to about 3, about 0.1 to about2, about 0.5 to about 5, about 0.05 to about 4, about 0.05 to about 3,about 0.05 to about 2, about 1 to about 5, about 1 to about 4, about 1to about 3, about 1.5 to about 5, about 1.5 to about 4, about 1.5 toabout 3, about 2 to about 5, about 2 to about 4, about 3 to about 5about 3 to about 4, or about 4 to about 5) by weight, based on 100 partsby weight of the composition or the microspheres comprising exendin,GLP-1 or a therapeutically effective GLP-1 or exendin analogue,biodegradable polymer(s), and coating material(s). An effective controlof drug release cannot be obtained if the content of the coatingmaterial is lower than the above scope, whereas the effect ofcontrolling the initial burst is not additionally increased even if thecontent of the coating material is increased to higher than the abovescope.

Each controlled-release microsphere according to the present disclosuremay have a smooth surface coated with the coating material, and anaverage size of about 1 to about 50 μm (e.g., about 5 to about 30 μm,about 1 to about 40 μm, about 1 to about 30 μm, about 1 to about 20 μm,about 1 to about 10 μm, about 5 to about 50 μm, about 5 to about 40 μm,about 5 to about 30 μm, about 5 to about 20 μm, about 5 to about 10 μm,about 10 to about 50 μm, about 10 to about 40 μm, about 10 to about 30μm, about 10 to about 20 μm, about 20 to about 50 μm, about 20 to about40 μm, about 20 to about 30 μm, about 30 to about 50 μm, about 30 toabout 40 μm, or about 40 to about 50 μm). The smooth surface of themicrosphere allows achievement of effective initial burst control andexcellent bioavailability.

Unlike the conventional form, the controlled-release microsphere or amicrosphere prepared from the composition/formulation of the presentdisclosure is coated with the coating material, allowing prevention ofan excessive/detrimental initial burst and an increase inbioavailability, which cannot be obtained in the conventional exendin,GLP-1 or a therapeutically effective GLP-1 or exendin analoguecontaining microsphere. In particular, an excessive/detrimental initialburst of exendin, GLP-1 or a therapeutically effective GLP-1 or exendinanalogue causes various side effects, such as vomiting, nausea,headache, and the like, and thus it is very important to lower theinitial burst amount to 5% or below. The controlled-release microsphereor a microsphere prepared from the composition (or formulation) of thepresent disclosure lowers the released amount for the initial 24 hoursto 5% or below. In order to decrease the side effects due toadministering exendin, GLP-1 or a therapeutically effective GLP-1 orexendin analogue containing controlled-release microsphere, the initialburst amount for the initial hour may be about 5% or below (e.g. about4% or below, about 3% or below, about 2% or below, or about 1% or below.The microspheres of the present disclosure comprise a coating layer ofthe coating material on the surface thereof, allowing effective controlof the initial burst to remove the side effects due to theexcessive/detrimental initial burst, and obtain a lasting and sufficientrelease of drug to achieve excellent bioavailability.

In an embodiment of the present disclosure, the formulation or themicrospheres may further comprise excipients, such as protectivecolloids and/or stabilizers.

The composition or the microspheres may further comprise one or moreprotective colloids selected from polyvinyl alcohols, albumins,polyvinylpyrrolidones, gelatins, and the like. Although the protectivecolloid has no special effect to prevent the excessive/detrimentalinitial burst of active ingredient contained in the microspheres, itplays a role to prevent aggregation between the microspheres and improvedispersibility. Considering such role, the content of the protectivecolloid may be about 0.02% (W/W) to about 1.0% (W/W) (e.g. about 0.02%to about 0.8%, about 0.02% to about 0.6%, about 0.02% to about 0.4%,about 0.05% to about 1.0%, about 0.04% to about 0.8%, about 0.05% toabout 0.5%, about 0.05% to about 0.4%, about 0.05% to about 0.3%, about0.05% to about 0.2%, about 0.1% to about 1.0%, about 0.1% to about 0.8%,about 0.1% to about 0.6%, about 0.1% to about 0.4%, about 0.1% to about0.3%, about 0.1% to about 0.2%, about 0.2% to about 1.0%, about 0.2% toabout 0.8%, about 0.2% to about 0.6%, about 0.2% to about 0.4%, about0.4% to about 1.0%, about 0.4% to about 0.8%, about 0.4% to about 0.6%,about 0.6% to about 1.0%, about 0.6% to about 0.8%, or about 0.8% toabout 1.0%), based on the weight of the composition, formulation or themicrospheres containing the exendin, GLP-1 or a therapeuticallyeffective GLP-1 or exendin analogue, biodegradable polymer(s), andcoating material(s).

In addition, in order to improve the stability of the microspheresduring freeze-drying, the composition/formulation or the microspheres ofthe present disclosure may further comprise excipients selected frommannitol, trehalose, sucrose, sodium carboxymethyl cellulose, and thelike, in an amount of about 5% (W/W) to about 30% (W/W), e.g. about 10%(W/W) to about 20% (W/W), based on the weight of the composition or themicrospheres comprising the exendin, GLP-1 or a therapeuticallyeffective GLP-1 or exendin analogue, biodegradable polymer(s), andcoating material(s).

Further, the composition, formulation or the microsphere of the presentdisclosure may further comprise any additives and excipientsconventionally used in drug formulation, the kind and the content ofwhich may be easily determined by one skilled in the relevant art.

The exendin, GLP-1 or a therapeutically effective GLP-1 or exendinanalogue comprising controlled-release microspheres utilized in themethods of present disclosure may be prepared by various methods, forexample by coating the surface of the microspheres through suspendingthe microspheres in the coating material solution during or after thepreparation of the microspheres, to prepare the controlled-releasemicrospheres. The method of preparing the microspheres may be performedby a double emulsion method (W/O/W method), single emulsion method (O/Wmethod), a phase-separation method, a spray drying method, and the like.

Specifically, the method of preparing the exendin, GLP-1 or atherapeutically effective GLP-1 or exendin analogue containingcontrolled-release microspheres may include the steps of: mixing activeagent(s) and biodegradable polymer(s) to prepare a W/O-type emulsion ora homogeneous mixture; and emulsifying by adding the emulsion or thehomogeneous mixture into an aqueous solution of a coating material toform a coating layer.

More specifically, in the case of using a double emulsion method, themethod may include the steps of emulsifying by mixing an activeingredient(s) aqueous solution and a biodegradable polymer dissolved inan organic solvent to form a primary emulsion (W/O-type); suspending theemulsion in an aqueous solution of a coating material to form aW/O/W-type emulsion; heating the W/O/W-type emulsion to remove thesolvent and harden the obtained microspheres; collecting and washing thehardened microspheres; and freeze-drying the microspheres. The organicsolvent may be any organic solvent that is capable of forming anemulsion by dissolving the biodegradable polymer and then being mixedwith an aqueous solution, and, for example, it may be one or moreselected from the group consisting of chloroform, ethylacetate,methylenechloride, and methylethylketone (e.g. methylenechloride). Inthis case, the coating material is contained in a secondary aqueousphase (outer aqueous phase of the W/O/W emulsion), to form a coatinglayer on the outside of the microspheres comprising at least one activeingredient (e.g., exendin, GLP-1 or a therapeutically effective GLP-1 orexendin-4 analogue, or a combination thereof) and the biodegradablepolymer, when the organic solvent is removed.

Alternatively, if a single emulsion method is employed, the method mayinclude the steps of dissolving the active ingredient(s) and abiodegradable polymer in an organic solvent to form a homogeneousmixture; adding an aqueous solution containing a coating material to theobtained mixture to form an emulsion; heating the emulsion to remove thesolvent and harden the obtained microspheres; collecting and washing thehardened microspheres; and freeze-drying the microspheres. The organicsolvent may be any organic solvent that is capable of completely mixingthe active ingredient(s) and the biodegradable polymer(s) to form ahomogeneous mixture, and of being mixed with an aqueous solution to forman emulsion. For example, the organic solvent may be a mixed solventwherein one or more selected from the group consisting of alcoholshaving 1 to 5 carbon atoms, glacial acetic acid, formic acid, dimethylsulfoxide, and n-methylpyrrolidone, and one or more selected from thegroup consisting of chloroform, ethyl acetate, methylethylketone, andmethylene chloride are mixed, and for example, wherein methanol andmethylene chloride are mixed. In this case, the surface thefinally-obtained microspheres has a coating layer thereon, byemulsifying the homogeneous mixture of the biodegradable polymer and theactive ingredient(s) and adding the coating material to an aqueoussolution for removing the organic solvent.

The method of preparing controlled-release microspheres may include thesteps of: mixing the active ingredient(s) and a biodegradable polymer toform an emulsion or a homogeneous mixture; solidifying the obtainedemulsion or homogeneous mixture to prepare primary microspheres; andsuspending the obtained primary microspheres in an aqueous solution of acoating material to form a coating layer on each microsphere.

The solidifying method has no limitation, and may be any solidifyingmethod conventionally used in the relevant art, for example aphase-separation method or a spray drying method. More specifically, ifa phase-separation method is employed in the solidifying step, themethod may include the steps of: mixing an aqueous solution of theactive ingredient(s) and a biodegradable polymer dissolved in an organicsolvent to form an emulsion, or mixing the active ingredient(s) and abiodegradable polymer in a mixed solvent to form a homogeneous mixturesolution; adding an oil, such as silicon oil, to the obtained emulsionor solution to prepare primary microspheres; adding a non-solvent forthe biodegradable polymer, such as a mixed solvent of an alcohol having1 to 5 carbon atoms and an alkane having 1 to 12 carbon atoms, such as amixed solvent of ethanol and heptane, to remove the organic solvent fromthe microspheres and harden the microspheres; suspending the obtainedmicrospheres in an aqueous solution of a coating material to form acoating layer on each microsphere; and collecting, washing, andfreeze-drying the coating layer-formed microspheres.

The organic solvent may be one or more (e.g. one, two, three, or four)selected from the group consisting of chloroform, ethyl acetate,methylene chloride, and methylethylketone, (e.g. methylene chloride).The mixed solvent may be one wherein one or more (e.g., one, two, three,four, five, or more) selected from the group consisting of at least onealcohol having 1 to 5 carbon atoms, glacial acetic acid, formic acid,dimethyl sulfoxide, and n-methylpyrrolidone, and one or more (e.g. one,two, three, or four) selected from the group consisting of chloroform,ethyl acetate, methylethylketone, and methylene chloride, are mixed(e.g. a mixed solvent of methanol and methylene chloride).

Alternatively, if a spray drying method is employed, the method mayinclude the steps of: mixing an aqueous solution of active ingredient(s)and a biodegradable polymer dissolved in an organic solvent to form anemulsion, or mixing the active ingredient(s) and a biodegradable polymerin a single solvent or a mixed solvent to form a homogeneous mixturesolution; spray-drying the obtained emulsion or solution to prepareprimary microspheres; suspending the obtained primary microspheres in anaqueous solution of a coating material to form a coating layer on eachmicrosphere; and washing and freeze-drying the coating layer-formedmicrospheres.

The organic solvent may be one or more (e.g. one, two, three, or four)selected from the group consisting of chloroform, ethyl acetate,methylene chloride, and methylethylketone (e.g. methylene chloride). Thesingle solvent may be one or more (e.g. one, two, three, four, or five)selected from the group consisting of glacial acetic acid and formicacid, and the mixed solvent may be one wherein one or more (e.g., one,two, three, four, or more) selected from the group consisting of atleast one alcohol having 1 to 5 carbon atoms, glacial acetic acid,formic acid, dimethyl sulfoxide, and n-methylpyrrolidone, and one ormore selected from the group consisting of chloroform, ethyl acetate,methylethylketone, and methylene chloride, are mixed (e.g. a mixedsolvent of methanol and methylene chloride).

The method may further include a step of adding a protective colloidmaterial through any conventional method, such as protective colloidmaterial may be added during the step of coating the microspheres withthe coating material.

The concentration of the coating material dissolved in aqueous phase orin aqueous solution may be from about 0.01 M to about 1 M (e.g. about0.1 M to about 0.5 M, about 0.01 M to about 0.8 M, about, about 0.01 Mto about 0.6 M, about 0.01 M to about 0.4 M, about 0.1 to about 1 M,about 0.1 M to about 0.8 M, about, about 0.1 M to about 0.6 M, about 0.1M to about 0.4 M, about 0.2 to about 1 M, about 0.2 M to about 0.8 M,about, about 0.2 M to about 0.6 M, about 0.2 M to about 0.4 M, about 0.4to about 1 M, about 0.4 M to about 0.8 M, about, about 0.4 M to about0.6 M, about 0.6 to about 1 M, about 0.6 M to about 0.8 M about, orabout 0.8 M to about 1 M). A lower concentration of the coating materialthan the above scope fails to completely coat the surface of themicrospheres with the coating material, whereas a higher concentrationof the coating material than the above scope results in a supersaturatedcoating material solution, which cannot result in an improved effect oncontrolling the initial burst, and thus the concentration of the coatingmaterial may be within the above scope.

Administration

The controlled-release composition of the present disclosure may beadministered through an oral or parenteral pathway (e.g. a parenteralpathway), such as an intravenous pathway, a subcutaneous pathway, anintramuscular pathway, an intraperitoneal pathway, and the like.Therefore, in an embodiment of the present disclosure, thecontrolled-release composition or formulation may be applied as aninjection solution in the form of a dispersed solution. The effectiveamount of the composition may be suitably adjusted according to the ageof the subject, the kind and the seriousness of the disease, and thecondition of the subject, and the dosage of the active ingredient in thecomposition may be from about 0.01 to about 100 μg/kg/day (e.g. about0.1 to about 10 μg/kg/day), which may be administered at once ordividedly at several times. The exact amount required will vary frompolypeptide to polypeptide and subject to subject, depending on thespecies, age, and general condition of the subject, the severity ofdisease that is being treated, the particular polypeptide used, its modeof administration, and the like. Thus, it is not possible to specify anexact “insulinotropic amount” or an amount useful in treating neuronaldisease or injury. However, an appropriate amount may be determined byone of ordinary skill in the art using only routine experimentation.

One skilled in the art would recognize how to monitor the effectivenessof the treatment and how to adjust the treatment accordingly. Forexample, blood glucose levels could be monitored with normoglycemiabeing the optimal effect of treatment. If blood glucose levels arehigher than preferred levels, then the amount of polypeptideadministered should be increased, and, if blood glucose levels are lowerthan preferred levels, then the amount of polypeptide administered wouldbe decreased.

The compounds may be administered orally, intravenously,intramuscularly, intraperitoneally, topically, transdermally, locally,systemically, intraventricularly, intracerebrally, subdurally, orintrathecally. One skilled in the art would know to modify the mode ofadministration, the pharmacologic carrier, or other parameters tooptimize the insulinotropic effects. The amount of active compoundadministered will, of course, be dependent on the subject being treated,the subject's weight, the manner of administration and the judgment ofthe prescribing physician.

Depending on the intended mode of administration, the pharmaceuticalcompositions may be in the form of solid, semi-solid or liquid dosageforms, such as, for example, tablets, suppositories, pills, capsules,powders, liquids, suspensions, lotions, creams, gels, or the like, e.g.in unit dosage form suitable for single administration of a precisedosage. The compositions will include, as noted above, an effectiveamount of the selected drug in combination with a pharmaceuticallyacceptable carrier and, in addition, may include other medicinal agents,pharmaceutical agents, carriers, adjuvants, diluents, etc. See, e.g.,Remington's Pharmaceutical Sciences, latest edition, by E.W. Martin MackPub. Co., Easton, Pa., which discloses typical carriers and conventionalmethods of preparing pharmaceutical compositions that may be used inconjunction with the preparation of formulations of the polypeptides andwhich is incorporated by reference herein. For solid compositions,conventional nontoxic solid carriers include, for example,pharmaceutical grades of mannitol, lactose, starch, magnesium stearate,sodium saccharin, talc, cellulose, glucose, sucrose, magnesiumcarbonate, and the like. Liquid pharmaceutically administrablecompositions can, for example, be prepared by dissolving, dispersing,etc., an active compound as described herein and optional pharmaceuticaladjuvants in an excipient, such as, for example, water, saline aqueousdextrose, glycerol, ethanol, and the like, to thereby form a solution orsuspension. If desired, the pharmaceutical composition to beadministered may also contain minor amounts of nontoxic auxiliarysubstances such as wetting or emulsifying agents, pH buffering agentsand the like, for example, sodium acetate, sorbitan monolaurate,triethanolamine sodium acetate, triethanolamine oleate, etc. Actualmethods of preparing such dosage forms are known, or will be apparent,to those skilled in this art; for example see Remington's PharmaceuticalSciences, referenced above.

For oral administration, fine powders or granules may contain diluting,dispersing, and/or surface active agents, and may be presented in wateror in a syrup, in capsules or sachets in the dry state, or in anonaqueous solution or suspension wherein suspending agents may beincluded, in tablets wherein binders and lubricants may be included, orin a suspension in water or a syrup. Where desirable or necessary,flavoring, preserving, suspending, thickening, or emulsifying agents maybe included. In certain embodiments, the oral administration form istablets or granules, which may be coated. Parental administration, ifused, is generally characterized by injection.

Injectables can be prepared in conventional forms, either as liquidsolutions or suspensions, solid forms suitable for solution orsuspension in liquid prior to injection, or as emulsions. A morerecently revised approach for parental administration involves use of aslow release or sustained release system, such that a constant level ofdosage is maintained. See, e.g., U.S. Pat. No. 3,710,795, which isincorporated by reference herein.

For topical administration, liquids, suspension, lotions, creams, gelsor the like may be used as long as the active compound can be deliveredto the surface of the skin.

EXAMPLES

The following examples are put forth so as to provide those of ordinaryskill in the art with a complete disclosure and description of how thecompounds, compositions, articles, devices and/or methods claimed hereinare made and evaluated, and are intended to be purely exemplary of thepresent disclosure and are not intended to limit the scope of what theinventors regard as their disclosure. Efforts have been made to ensureaccuracy with respect to numbers (e.g., amounts, temperature, etc.), butsome errors and deviations should be accounted for.

Statistics:

Values are expressed as means±S.E.M. The Kolmogorov-Smirnov test wasused to determine normality of distributions. Student's t test,Mann-Whitney tests, Fisher Exact test or 1- and 2-way ANOVAs were usedfor statistical analysis as indicated in results. ANOVA on ranks wasused when the normality assumption was violated. Post-hoc Newman-Keulstest or Dunn's test was used for all pairwise multiple comparisons. Astatistically significant difference was defined as p<0.05.

Example 1. Pharmacokinetics of Exendin-4 and Sustained Release in Plasma

PT302, a sustained release formulation of Exendin-4, contains a mixtureof polymers (98%) and Exendin-4 (2%). Plasma levels of Exenatide wereanalyzed after injection with the Sustained Release formulation ofexendin-4 (PT302). In particular, the pharmacokinetics of a single doseof PT302 was examined using 6 adult (9 weeks old) male Sprague-Dawleyrats. PT302 was freshly dissolved in diluent and 2 mg/kg wasadministered subcutaneously. Blood was collect at 0 hours, 0.5 hours,and 1 hour after injection, as well as days 1, 3, 5, 7, 9, 11, 14, 18,21, and 26 post injection. Plasma levels of Exendin-4 were quantified bythe Peptron Exenatide EIA Kit (Peptron, Daejeon, South Korea). The datais shown in FIG. 1A with a Cmax of 1.85 ng/ml, a Tmax of 12.5 days, anda AUC of 18.55 ng*d/ml (values calculated from individual data of all 6animals). As seen in FIG. 1A, the sustained-release formulation PT302provides prolonged Exendin-4 plasma levels from a single subcutaneousinjection acceptable for one to two weeks dosing regimen.

The pharmacokinetics of a single dose of PT302 at various dosages (2.4mg/kg, 4.8 mg/kg, and 9.6 mg/kg) was examined using 6 adult (9 week old)male Sprague-Dawley rats per group. PT302 was freshly dissolved indiluent and administered as indicated subcutaneously. Blood wascollected at 0 hours, 0.5 hours, and 1 hour after injection, as well asdays 1, 3, 7, 10, 14, 17, 21, 24, 28, and 31 post injection. Plasmalevels of Exendin-4 were quantified as discussed above. The data isshown in FIG. 1B with a Cmax of 2.23 ng/ml, a Tmax of 14.83 days, andAUC of 21.13 ng*d/ml for the 2.4 mg/kg dose; a Cmax of 5.21 ng/ml, aTmax of 16.17 days, and AUC of 49.46 ng*d/ml for the 4.8 mg/kg dose; anda Cmax of 9.42 ng/ml, a Tmax of 17.17 days, and AUC of 87.14 ng*d/ml forthe 9.6 mg/kg dose. FIG. 1B demonstrates that the sustained-releaseformulation PT302 provides prolonged Exendin-4 plasma levels from asingle subcutaneous injection directly related to the dose level ofPT302 administered.

PT304, a sustained release formulation of Exendin-4, contains a mixtureof polymers (96%) and Exendin-4 (4%). Plasma levels of Exenatide wereanalyzed after injection of 6 adult (9 weeks old) male Sprague-Dawleyrats with the Sustained Release formulation of exendin-4 (PT304). PT304was freshly dissolved in diluent and 4 mg/kg was administeredsubcutaneously. Blood was collect at 1 hour, and 3 hour after injection,as well as days 1, 4, 7, 11, 14, 18, 21, 25, 28, 32, 35, 39, and 42 postinjection. Plasma levels of Exendin-4 were quantified by the PeptronExenatide EIA Kit. The data is shown in FIG. 2 with a Cmax of 3.82ng/ml, a Tmax of 14.17 days, and a AUC of 48.34 ng*d/ml (valuescalculated from individual data of all 6 animals). As seen in FIG. 2,the sustained-release formulation PT304 provides prolonged Exendin-4plasma levels from a single subcutaneous injection acceptable for two tofour weeks dosing regimen.

The pharmacokinetics of PT302 for a 10 week period was examined in 10adult (9 weeks old) Sprague-Dawley rats per group. The rats weresubcutaneously injected with a dose of 2 mg/kg of PT302 weekly or 4mg/kg of PT304 every other week. The PT302 and PT304 were prepared asdiscussed above, and blood collected at 1 hour and 3 hours after thefirst injection, as well as on days 1, 3, 5, 7, 10, 14, 21, 28, 35, 42,49, 56, 63, 70, 77, 84, and 91 days after the first injection. Serumlevels of Exendin-4 were quantified as discussed above, and is shown inFIG. 3. The weekly injected rats had a Cmax of 5.27 ng/ml, a Tmax of51.60 days, and a AUC of 236.42 ng*d/mL, while the fortnightly injectedrats had a Cmax of 5.08 ng/ml, a Tmax of 47.89 days, and a AUC of 211.51ng*d/mL.

Example 2. Pre-Treatment with PT302 Reduces Meth-Mediated Rotation inthe 6-OHDA Rat Model of Parkinson's Disease

The animals were treated with vehicle (9 rats), 0.4 mg/kg PT302 (lowdose; 9 rats), or 2 mg/kg PT302 (high dose; 10 rats) on the days definedin FIG. 4A (i.e., on days 16 and 2 prior to a 6-OHDA unilateral lesionof the medial forebrain bundle, and on days 12, 26 and 40 afterlesioning). As shown in FIGS. 4A and 4B, rats were subjected tometh-mediated rotation on days 20, 30 and 45 post-lesioning, and wereeuthanized on day 47. For lesioning, rats were anesthetized by chloralhydrate (400 mg/kg, i.p.) and placed in a stereotaxic frame. 6-OHDA(2.76 μg/μl×5 μl in 0.9% NaCl containing 0.2 mg/ml ascorbic acid) wasunilaterally injected into the medial forebrain bundle (−4.4 mm AP, 1.2mm ML relative to bregma and 8.4 mm below skull) over 4 minutes througha Hamilton microsyringe held by a stereotaxic arm. The microsyringe waslowered to the desired target locus in the brain using micromanipulatorsattached to the stereotaxic frame. The speed of injection (0.5μl/minute) was controlled by a syringe pump (Micro 4, WPI, Sarasota,Fla.). The needle was removed 5 minutes after the injection. A piece ofbone wax was placed on the burr hole to prevent the leakage of fluid.The wound was sutured or clipped. Body temperature was monitored with athermistor probe and maintained at 37° C. with a heating pad duringanesthesia. After recovery from the anesthesia, body temperature wasfurther maintained at 37° C. for 3 hours using a temperature controlledincubator.

Meth-induced Rotational behavior [Liu D M, Lin S Z, Wang S D, Wu M I,Wang Y. Xenografting human T2 sympathetic ganglion from hyperhidroticpatients partially restores catecholaminergic functions inhemi-Parkinsonian athymic rats. Cell Transplant 1999; 8:563-91; and LuoY, Hoffer B J, Wang Y. Rotation, Drug-induced. In: Kompoliti K, VerhagenMetman L, editors. Encyclopedia of Movement Disorders. Oxford: AcademicPress, 2010. p 49-51] was evaluated using an 8-channel rotometer system(RotoMax, AccuScan Instruments, Inc). Animals were challenged withmethamphetamine (2.5 mg/kg) 6 days after 6-OHDA lesioning as previouslydescribed [Yin L H, Shen H, Diaz-Ruiz O, Backman C M, Bae E, Yu S J,Wang Y. Early post-treatment with 9-cis retinoic acid reducesneurodegeneration of dopaminergic neurons in a rat model of Parkinson'sdisease. BMC Neurosci 2012; 13:120]. Methamphetamine is an indirectagonist that induces release of dopamine in the brain. Rats that receiveunilateral injections of 6-OHDA in the nigrostriatal dopaminergic systemare used as a model for PD. These animals exhibit ipsilateral rotationsafter administration of indirect dopamine agonists (such asmethamphetamine) and contralateral rotations after direct dopamineagonists (such as apomorphine). These behaviors are related tounilateral changes in the expression of striatal dopaminergic markers.

As shown in FIG. 4B, treatment with PT302 significantly reduced rotationin both high and low dose of PT302 treatment group (p=0.018, F2,87=4.309, two way ANOVA in low dose group) relative to vehicle. Apost-hoc Newman-Keuls test indicated that the high dose of PT302significantly attenuated meth-mediated rotation (p=0.037). Thus,sustained, steady-state administration of Exendin-4 in the form of PT302significantly mitigated behavioral effects induced by a unilateral6-OHDA lesion of the medial forebrain bundle in rats (a wellcharacterized animal model of PD), providing neuroprotective activity.

Plasma levels of Exendin-4 were quantified as discussed above. As shownin FIG. 4C, the average Exendin-4 plasma level was 30.845 pg/ml (n=10)in high dose rats and 8,990 pg/ml (n=9) in low dose rats. However, whenthe outlier rats/measurements (rat 1, 10 and 12) are removed, theaverage Exendin-4 plasma level was 5,596 pg/ml (n=8) in the high doserats and 574 pg/ml (n=8) in the low dose rats.

Example 3. Post-Treatment with PT302 Reduced Meth-Induced RotationalBehavior in 6-OHDA Lesioned Rats

The use of the unilateral 6-OHDA lesion of the medial forebrain bundlerodent model of PD, described in Example 2, can be combined with thepost-treatment of a potential drug, as shown in the scheme in FIG. 5A.In this scenario, rodents are challenged with a unilateral 6-OHDA lesion(0 day), and treatment is initiated 6 days thereafter. This is a moredifficult rodent model of PD to treat, as dopaminergic cell death hasalready been initiated and is ongoing prior to treatment. Nineteen ratswere lesioned as described above. The meth-induced rotation was examinedas discussed above with animals that rotated in excess of 300 turns/hourbeing separated into 2 groups to equalize group rotational behavior forvehicle or PT302 groups before the initiation of treatment. As outlinedin FIG. 5A, meth-induced rotation was examined on 6, 20, 30 and 45 daysafter lesioning and the animals (adult male Sprague-Dawley rats-2 monthsold upon arrival) were treated with vehicle (s.c., n=1) or PT302 (100mg/kg containing 2.0 mg/kg Exendin-4, s.c., n=8) on days 6, 20, and 34after 6-OHDA lesioning. The PT302 was prepared as described above. Theanimals were euthanized on day 47 after lesioning. Blood and brainsamples were collected, and plasma was separated and stored (−80° C.).Exendin-4 was measured in the plasma collected.

As shown in FIG. 5B, PT302 significantly reduced meth-induced rotationalbehavior in the unilaterally 6-OHDA-lesioned rats (p=0.032, two wayANOVA), as compared to the vehicle control.

TH was examined by immunohistochemistry. Specifically, serial cryostatsections of the entire brain were cut at 25 μm thickness. One seriesfrom every sixth section was stained for TH. To control for stainingvariability, specimens from all experimental groups were included inevery batch and reacted together in a net well tray under the sameconditions. Sections were rinsed in 0.1M phosphate buffer (PB), blockedwith 4% bovine serum albumin (BSA) and 0.3% Triton x-100 in 0.1M PB.Sections were then incubated in primary antibody (mouse monoclonalanti-TH diluted in 4% BSA and 0.3% Triton x-100 in 0.1M PB,concentration 1:100; Chemicon, Temecula, Calif.) for 17-19 hours at 4°C. Sections were then rinsed in 0.1M PB and incubated in secondaryantibodies for 1 hour, followed by incubation for 1 hour withavidin-biotin-horseradish peroxidase complex. Sections were mounted onslides, and coverslipped. Control sections were incubated withoutprimary antibody.

TH immunoreactivity in the striatum was measured by the ImageJ and wasaveraged from 3 brain sections chosen so that the anterior commissurewas visible. TH immunoreactivity in the substantia nigra was measuredevery 360 μm throughout the midbrain (from bregma −4.2 mm to −6.0 mm). Atotal of 5 brain sections from each animal was used. The volume of thesubstantia nigra was analyzed using Cavalieri's method.

PT302 Reduced 6-OHDA-Mediated Dopaminergic Neurodegeneration in theStriatum.

Representative striatal TH immunostaining and plasma Exendin-4 levelsfrom 3 rats (#866, 883, 886) receiving vehicle and 3 rats (#881, 875,882) receiving PT302 are shown in FIG. 5C (plasma concentrations ofexendin-4 in these same animals was quantified and are also noted inFIG. 5C). As shown in FIG. 5D, the injection of 6-OHDA significantlyreduced striatal TH immunoreactivity in animals receiving vehicle, whilePT302 significantly increased TH immunoreactivity in the lesionedstriatum (*p<0.001, 2-Way ANOVA). L=lesioned side; non-L-non-lesionedside; veh=animals receiving vehicle; PT=PT302.

TH immunoreactivity in the substantia nigra was measured by the ImageJand was averaged from 3 brain sections chosen so that the anteriorcommissure was visible. Representative TH immunostaining from animalsreceiving vehicle (Rat #866, #883, #886) or PT302 (Rat #88 1, #875,#882) are shown in FIG. 5E (also shown are plasma levels of exendin-4 inthe same animals). The TH immunoreactivity in substantia nigra wasquantified every 360 um from bregma −4.2 mm to −6 mm, and is shown inFIG. 5F. The injection of 6-OHDA significantly reduced substantia nigraTH immunoreactivity in animals receiving vehicle, while PT302significantly mitigated the loss of TH immunoreactivity in the lesionedsubstantia nigra (*p<0.001, 2-Way ANOVA). L=lesioned side;non-L-non-lesioned side; veh=animals receiving vehicle; PT=PT302

PT302 Post-Treatment Protects TH+ Neurons in the Lesioned SubstantiaNigra.

The brains were sectioned and immunohistochemistry performed asdescribed above. TH+ neurons were found on the non-lesioned side of thebrain (FIGS. 5G and 5H). Almost no TH+ neurons or fibers were found inthe substantia nigra on the lesioned side of the brain (rat #886; FIG.51). Treatment with PT302 partially protected TH+ neurons (FIGS. 5J, 5K,and 5L).

Exendin-4 Mediated Protection in TH Neurons is Associated with thePlasma Exendin 4 Level.

FIG. 5M shows the significant correlation found between normalizedstriatal TH (i.e. lesioned/non-lesioned side) immunoreactivity andplasma Exendin 4 levels within the same animals (p=0.002, R=0.663). FIG.5L shows the significant correlation observed between plasma Exendin 4levels and TH immunoreactivity in the substantia nigra on the lesionedside (p<0.001, R=0.842).

Example 4. Pre-Treatment with PT302 Reduces Meth-Mediated Rotation in a6-OHDA Rat Model of PD

As shown in FIG. 6A, the animals were treated subcutaneously with Ex-4(5 μg/kg, BID) or PT302 (0.4 mg/kg) 7 days before and 7 days after6-OHDA lesioning, as described above. The 5 μg/kg BID dose of Exendin-4used in this study is higher than can be achieved in humans (see Table 1below), and a lower dose of approximately 1 μg/kg BID is equivalent toboth the human dose and the PT302 dose used within the study. Both Ex-4(5 μg/kg BID) and PT302 (0.4 mg/kg) treatment significantly reducedrotation (p=0.005 in Ex-4 and 0.002 in PT302 group) in the 6-OHDAlesioned rats (Figure. 6B).

Pre-Treatment with Either Exendin-4 or PT302 Protected Against6-OHDA-Mediated Dopaminergic Neurodegeneration in the Substantia Nigra.

Representative TH immunoreactivity from sham animals and 6-OHDA-lesionedanimals receiving vehicle, Ex-4 (5 μg/kg, BID) or PT302 (0.4 mg/kg) isshown in FIG. 6C. The injection of 6-OHDA significantly reduced THimmunoreactivity on the side of the lesion (noted as ipsi in FIG. 6C).Representative TH immunoreactivity in substantia nigra was quantifiedand shown in FIG. 6D. Treatment with PT302 and Ex-4 significantlyreduced the loss of TH immunoreactivity on the 6-OHDA lesioned side(evaluated by expressing TH immunoreactivity as a ratio ofimmunoreactivity present on the side of the lesion (ipsi) as a percentof immunoreactivity present in the same animal on the control unlesionedside (contra)).

Example 5. Post-Treatment with PT302 Reduces Meth-Mediated Rotation in a6-OHDA Rat Model of Parkinson's Disease

Animals were treated with Ex-4 (1 μg/kg, BID from day 2) or PT302 (0.4mg/kg, once on day 2) after 6-OHDA lesioning and meth-mediatedrotational behavior was examined on day 9 after lesioning, as describedabove (FIG. 7A). As shown in FIG. 7B, PT302 significantly reducedrotation behavior in the unilaterally 6-OHDA-lesioned rats (p=0.0075).In contrast, Exendin-4 did not reduce rotational behavior in theunilaterally 6-OHDA-lesioned rats. Thus, the use of Exendin-4 at a humanequivalent dose (1 μg/kg BID in rat) proved ineffective in mitigatingmeth-induced rotation, whereas PT302 at a human translatable dose provedeffective in the 6-OHDA rat PD model. When the Exendin-4 dose wasescalated to an equivalent that is higher than the human achievable dose(5 μg/kg BID, as in Example 4), Exendin-4 could provide mitigation of6-OHDA induced impairments. By contrast, an equivalent clinicallytranslatable dose of PT302 provides favorable actions in both Example 4and 5.

Example 6. Post-Treatment with PT302 Improved Toxin-Induced BehaviorDeficit in a MPTP-Mouse Model of PD

Animals were treated with Ex-4 (16.7 ug/kg, BID from day 6) or PT302(0.6 mg/kg, on days 6, 20, and 34) after the induction of Parkinsonismby MPTP, as described above (FIG. 8A). Specifically, Parkinsonism wasinduced by the systemic administration of 30 mg/kg MPTP daily, for 5days. See, e.g., Filichia E, Hoffer B, Qi X, Luo Y. Inhibition of Drp1mitochondrial translocation provides neural protection in dopaminergicsystem in a Parkinson's disease model induced by MPTP. Sci Rep. 2016;6:32656. Treatment with either Ex-4 or PT302 was initiated one day afterthe first MPTP dose, and continued for 18 days. The selected doses ofEx-4 (16.7 ug/kg BID subcutaneous) and PT302 (0.4 mg/kg single dosesubcutaneous) were equivalent in relation to Ex-4 amount delivered, andprovided 601.2 ug/kg and less than 600 ug/kg, respectively, over the 18days of treatment. A wire grip test was utilized to evaluate locomotorcoordination of all groups of animals on day 18. The wire grip test(also known as the paw grip endurance (PaGE) method and the gripforce-recording test) are often used as measures of motor strength. PaGEis designed to assess the grip strength of mice, which may be indicativeof a decrease in motor skills and was performed here as described byJessica A L, et al. (Jessica A. L. Hutter-Saunders, Howard E. Gendelman,R. Lee Mosley. Murine Motor and Behavior Functional Evaluations forAcute 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine (MPTP) Intoxication.J Neuroimmune Pharmacol. 2012; 7(1): 279-288). Briefly, each mouse wasplaced on a wire lid from a conventional rodent housing cage; the lidwas gently shaken to induce gripping and turned upside down (180°). Thelatency until the mouse released both hind limbs was measured inseconds. Each mouse was tested three times with an arbitrary maximum of240 s, and the longest latency to fall or release both hind limbs wasrecorded (Jessica, et al. 2012).

As shown in FIG. 8B, the administration of the dopaminergic cell toxin,MPTP, resulted in a significantly reduced latency time in the Grip test(MPTP: 94.5 sec vs. the combined Control group without MPTP: 148.3 sec;p=0.02). PT302 significantly increased the time to fall from the wire inthe MPTP-treated mice (118.3 sec, not statistically different from thecombined Control group value), while Exendin-4 (administered twicedaily, in a manner similar to human use of Byetta (i.e., immediaterelease Ex-4)) did not mitigate the toxin-induced behavioral deficit inthe MPTP-treated mice (72.9 s, p+0.01 vs. the combined Control groupvalue) (FIG. 8B: across all groups, the number of mice was between 7 and10).

Example 7. Delivering Ex-4 to the Central Nervous System by SustainedRelease Exendin-4 is Effective at Achieving Therapeutic Amounts ofExendin-4 in the Cerebral Spinal Fluid

Exendin-4 (injection and minipump) and sustained release formulation ofExendin-4 (PT302) were administered as described in Table 1 to adultmale Sprague-Dawley rats (9 weeks old) were used for this study. Bloodand cerebrospinal fluid (CSF) were collected on day 14 after firstinjection of Exendin-4 administration for measurement of Exendin-4levels. Plasma and CSF levels of Exendin-4 were quantified as describedabove. As shown in Table 2, Exendin-4 was detected in the plasma and CSFof the sustained release formulation group and the minipump administeredExendin-4 group, while Exendin-4 was below the detectable limits in theCSF in the twice daily (BID, immediate release) Exendin-4 group. This isin contrast to the high levels of Exendin-4 detected in the plasma ofthis Exendin-4 group. CSF/plasma level ratios ranged from 0.0081 (or0.81%) to about 0.0412 (or 4.12%) with an average of 0.018 (or 1.8%) wasobserved in pump administered Exendin-4 with doses ranging from 3.5-15pM/kg/min. Likewise, CSF/plasma level ratios ranged from 0.0117 (or1.17%) to about 0.016 (or 1.6%) in animals administered PT302 0.46-2.0mg/kg/14 days. This data demonstrates that the sustained release ofExendin-4 provides greater levels of Exendin-4 into the CNS.

TABLE 1 Experimental procedure Ex-4 BID Ex-4 in 14 day (immediaterelease) Mini-pump PT302 Rational Animals 2.3 ug/kg/day (1.15 BID) 3.5pM/kg/min 0.46 mg/kg/14 days Daily dose conversion 5 rats/group 4.6ug/kg/day (2.3 BID) 7.0 pM/kg/min 0.92 mg/kg/14 days Daily dose x2 5rats/group 10.0 ug/kg/day (5 BID) 15 pM/kg/min 2.0 mg/kg/14 days Matchplasma level 5 rats/group

TABLE 2 Plasma and Cerebral Spinal Fluid Levels in rats treated withExendin-4 via a Minipump, PT302, and Exendin-4 CSF/Plasma FormulationDose Plasma CSF ratio Pump (low) 3.5 pM/kg/min 394.8484 14.887210.041279 Pump (medium) 7.0 pM/kg/min 4293.409 35.0529 0.008159 Pump(high) 15 pM/kg/min 7899.634 137.688 0.0185 PT302(low) 0.46 mg/kg/14days 1853.329 18.28185 0.01612 PT302(medium) 0.92 mg/kg/14 days 4438.49654.37036 0.012756 PT302(high) 2.0 mg/kg/14 days 2316.801 29.980720.011789 Ex-4 low 2.3 μg/kg/day (1.15 BID) 93.479 Under LLOQ N/A Ex-4Medium 4.6 μg/kg/day (2.3 BID) 576.886 Under LLOQ N/A Ex-4 High 10μg/kg/day (5 BID) 5819.282 Under LLOQ N/A

Example 8. Sustained Release Exenatide Treatment of Mild Traumatic BrainInjury (mTBI) Mice Improves Novel Object Recognition

The head injury was performed using the weight drop trauma device aspreviously described (Tweedie et al. 2007). The device consists of ametal tube (90 cm long, 1.3 cm inner diameter) and a sponge under thetube to support the head of the mice. The mice were lightly anesthetizedby inhalation of isoflurane and put under the device. A metal weight (30grams) was dropped from the top of the tube to strike the head of themouse at the temporal side between the corner of the eye and the ear.Immediately following the injury, the mice were put back in theiroriginal cage for recovery. This head injury procedure is well toleratedby mice and results in a diffuse neuronal loss in the hippocampus andcerebral cortex on the side of injury, and is accompanied by cognitiveimpairment in visual and spatial memory tests (Deselms H, Maggio N,Rubovitch V, Chapman J, Schreiber S, Tweedie D, Kim D S, Greig N H, PickCG. Novel pharmaceutical treatments for minimal traumatic brain injuryand evaluation of animal models and methodologies supporting theirdevelopment. J Neurosci Methods. 2016; 272:69-76).

Sustained release PT302 was administered (0.6 mg/kg, s.c.) 1 hour posthead injury, as described above (FIG. 9A). The mice were tested 7 dayspost injury for the novel object recognition paradigm, which isroutinely used to evaluate recognition memory in rodents.Non-compromised rodents display an inherent tendency to explore novelobjects in their immediate locations. This feature of mouse behaviorallows for the assessment of visual recognition memory function. Perhapsmore importantly, it also allows for the assessment of the effects ofdifferent stimuli on this inherent activity. The test utilizes twotrials. In the first trial, animals are allowed to examine two objectsfor a defined amount of time-5 minutes. The second trial takes place 24hours after the first, in which the animals are challenged with twoobjects where one is the same as in the first trial and the other is newto the animal. In the second trial mice are also allowed to explore theobjects for 5 minutes. A discrimination preference index is calculatedand used to evaluate the animal's recognition memory. The index iscalculated by the following: the time the animal spends near the novelobject minus the time spent near the familiar object, divided by the sumof the time near the novel and familiar objects (Dix S L, Aggleton J P.Extending the spontaneous preference test of recognition: evidence ofobject-location and object-context recognition. Behav. Brain Res. 1999;99:191-200). As shown in FIG. 9B, administration of Exenatidesignificantly increased novel object recognition in mTBI mice (n=5), ascompared to untreated mTBI mice (n=7), thereby demonstrating that thePT302 treated mice mitigated the visual recognition impairment inducedby the mTBI.

Example 9. Examination of Plasma Exendin-4 Level in Normal ICR Mice

Exendin-4 plasma concentration was measured in normal ICR mice 7 daysafter subcutaneous administration of PT302 (0.1, 0.3, 0.6, 1.0, and 2.0mg/kg). Plasma levels of Exendin-4 were quantified as described above.The plasma Exendin-4 level is sustained and dose-dependently accumulatedup to about 4000 pg/ml until 7 days after injection (FIG. 10A).

Example 10. Examination of Plasma Exendin-4 Levels in Normal andTraumatic Brain Injury Mice

Exendin-4 plasma levels were measured in normal mice and TBI model mice7 days after subcutaneous administration of PT302 (0.6 mg/kg). Plasmalevels of Exendin-4 were quantified as described above. No differenceswere observed in Exendin-4 plasma levels between normal mice andTBI-induced mice (FIG. 10B).

Example 11. Sustained Release Exenatide Maintains Exendin-4 PlasmaLevels for an Extended Period of Time

Normal ICR mice received a single subcutaneous injection of PT302 atthree different doses: 0.024 mg/kg, 0.12 mg/kg, and 0.6 mg/kg. Blood wascollected at 0 hours, 0.5 hours, and 1 hour after the first injection,and on day 1, 3, 7, 14, and 21 days for plasma measurement. The plasmaconcentration of Exendin-4 was quantified as described above. As shownin FIG. 10C, a single dose of PT302 maintained Exendin-4 plasma levelsfor more than 20 days.

Example 12. Sustained Release Exenatide Significantly IncreasesRecognition of Novel Objects and New Arms of a Maze Seven Days afterTraumatic Brain Injury

The head injury was performed as described above and the miceimmediately placed in their original cage for recovery. PT302 (0.024mg/kg, 0.12 mg/kg, and 0.6 mg/kg) was administered subcutaneously tomice as a single injection 1 hour after the induction of TBI. Behavioralassessments (novel object recognition and Y-maze test) were conducted 7days post mTBI. The Y-maze paradigm is commonly used to evaluatespontaneous exploration and responsiveness to novel environments andspatial working memory function (Deselms, et al., 2016). The testapparatus is constructed out of identical black Plexiglass arms (8×30×15cm) where the arms extend from a central point at a 120° angle from thecenter. Inside each arm is a different spatial cue designed to give themouse a visual memory anchor. Typically, there are two trials undertakena few minutes apart; here the trials were undertaken at 5 minuteintervals. For each first trial, the start arm is selected randomly.Each animal is placed into the center point of the Y maze environment;during the first 5 minute trial, one of the two arms is randomly closed,during the second 2 minute trial all three arms are open forexploration. The total amount of time the mouse explored in each armduring the second trial is recorded. To avoid any possible confounds,between trials the T maze is thoroughly cleaned. The time spent in thenovel previously unexplored arm over the familiar previously exploredarm is used to assess for any behavioral differences between each animaltreatment group i.e. (the time spent in new arm minus time spent infamiliar arm)/(time spent in new arm plus time spent in familiar arm).

Vehicle-treated mTBI mice suffered from visual memory deficits and spentless time near the novel object as compared to control mice (p<0.001)(FIG. 11A). A high preference for the new object as compared tountreated mTBI mice was observed in mice treated with a singlesubcutaneous injection of PT302 1 hour following mTBI induction at adose of 0.12 mg/kg (p<0.05) and 0.6 mg/kg (p<0.01) (FIG. 11A).

mTBI-challenged mice demonstrated a significant impairment in spatialmemory, and spent less time in the new arm of the Y maze as compared tosham (control) animals (p<0.001) (FIG. 11B). A single subcutaneousinjection of PT302 1 hour following mTBI induction at a dose of 0.12mg/kg and 0.6 mg/kg ameliorated the mTBI-spatial memory deficit ascompared to untreated mTBI mice (p<0.01) (FIG. 11B). [F(4,50)=4.83,p=0.002, Fisher's LSD post hoc].

All groups spent approximately equal time in the open arm of theelevated plus maze and could not be differentiated from one another withregard to their anxiety-like behavior (FIG. 11C); importantly indicatingthat anxiety-like behavior was not a confounding factor in the priornovel object recognition and Y-maze paradigms (p>0.05). [F(4,36)=0.28,p=0.89].

Example 13. Sustained Release Exenatide Significantly IncreasesRecognition of Novel Objects and New Arms of a Maze Thirty Days afterTraumatic Brain Injury

The head injury was performed as described above and the miceimmediately placed in their original cage for recovery. PT302 (0.6mg/kg) was administered subcutaneously to mice as a single injection 1hour after the induction of TBI. Behavioral assessments (novel objectrecognition and Y-maze test) were conducted 30 days post mTBI.

Vehicle-treated mTBI mice suffered from visual memory deficits and spentless time near the novel object as compared to control mice (p<0.001;FIG. 12A). A high preference for the new object as compared to mTBI micewas observed in mice that were treated with a single subcutaneousinjection of PT302 1 hour following mTBI induction at a dose of 0.12mg/kg or 0.6 mg/kg (p<0.01 and p<0.001, respectively; FIG. 12A).

mTBI-challenged mice demonstrated a significant impairment in spatialmemory, and spent less time in the new arm of the maze as compared tosham/control animals (p<0.001; FIG. 12B). A single subcutaneousinjection of PT302 1 hour following mTBI induction at a dose of 0.6mg/kg ameliorated the mTBI-spatial memory deficit as compared to mTBIalone (p<0.01; FIG. 12B).

All groups spent approximately equal time in the open arm of the mazeand could not be differentiated from one another in regards to theiranxiety-like behavior (FIG. 12C), indicating that anxiety-like behaviorwas not a factor in the prior novel object recognition and Y-mazeparadigms (p>0.05).

Example 14. PT302 Administration Prevented the Decline in NeuNImmunoreactivity Subsequent to Traumatic Brain Injury in Mouse TemporalCortical and Hippocampal Regions

NeuN is a mature neuron marker, which can be used to assess neuron lossdue to traumatic brain injury. For evaluation of NeuN cells in definedbrain regions, mice were anesthetized by excess ketamine+xylazineadministration and were immediately perfused transcardially withphysiological buffered saline followed by 4% paraformaldehyde ((PFA) in0.1 M phosphate buffer, pH 7.4). Their brains were removed, fixedovernight (4% PFA in 0.1 M phosphate buffer, pH 7.4), and then placed in30% sucrose for 48 hours. Coronal sections (30 μm) were cut on acryostat, placed in cryoprotectant, and stored at −20° C. until use.Thereafter, 5 sections of cortex and 5 of hippocampus were blocked byincubation with 0.1% Triton X-100 in phosphate-buffered saline (PBST)and 10% normal horse serum for 1 hour at 25° C. The primary antibody,mouse anti-neuronal nuclei (NeuN; 1:50, Millipore, Danvers, Mass., USA,Cat # MAB3377) was then dissolved in PBST and 2% normal horse serum andincubated with the sections for 48 hours at 4° C. Following rinsing inPBST, the sections were incubated for 1 hour at 25° C. with DyLight™594-conjugated AffinityPure Donkey Anti-rabbit IgG and DyLight™488-conjugated AffinityPure Donkey Anti-mouse IgG (1:300; JacksonLaboratories, Bar Harbor, Me., USA). After rinses in PBST, the sectionswere mounted on dry gelatin-coated slides and evaluated for fluorescencewith a Zeiss LSM 510 confocal microscope with ×20 and ×63 lens (CarlZeiss, Jena, Germany). For each brain, three to five sections were takenand the average numbers of cells within the hippocampus and the temporalcortex were calculated within defined fields of either 140² or 440² μM.Evaluation of immunohistochemical slides for immunofluorescence wasundertaken in a blinded manner, and the omission of the primary antibodywas routinely undertaken in the generation of negative control sections.Analyses were performed by Imaris program for color quantification(Bitplane AG, Zurich, Switzerland).

FIG. 13A shows representative images of NeuN (red (when evaluated incolor)) positive neurons in the cortex, CA3 and dentate gyrus of controlmice, untreated mTBI mice, and PT302 treated mTBI mice (0.6 mg/kg 1 hourpost mTBI) 30 days post mTBI. Bar graphs of FIGS. 13B, 13C, and 13D showthe quantification of neuronal survival in the cortex, CA3 and thedentate gyrus, respectively, as was measured by the number of neuronspositively stained with anti-NeuN in sham control, mTBI and mTBI+PT3020.6 mg/kg groups. (**p<0.01, ***p<0.001). Values are mean±SEM.Administration of sustained-release Exendin-4 in the form of PT302prevented the neuron loss observed due to traumatic brain injury.

Example 15. PT302 Administration Decreased the Number of DegeneratingNeurons in mTBI Mice

Fluoro-Jade® C is a fluorescent stain that labels injured, degeneratingbrain neurons, which may be utilized to assess neuron loss due totraumatic brain injury. Ionized calcium-binding adaptor molecule 1(IBA1) is specifically expressed in microglia and upregulated inactivated microglia, which may be utilized as a marker ofneuroinflammation. Mice were euthanized and their brains prepared forimmunohistochemical analyses as described above. Coronal sections fromhippocampus and parietal cortex (40 μm) were cut on a cryostat andcollected in a cryoprotectant solution. CA1, CA3 and dentate gyrus fromthe hippocampus, in addition to the parietal cortex were analysed.

For FluoroJade C staining, brain sections were first immersed in asolution containing 1% NaOH in 80% ethanol for 5 minutes. They wererinsed for 2 minutes in 70% ethanol, washed in distilled water, thenincubated in 0.06% potassium permanganate solution for 10 minutes.Following a water wash, slides were incubated in the FJC stainingsolution (obtained by adding 4 ml of a FJC 0.01% stock solution indistilled water to 96 ml of 0.1% acetic acid) and stained for 10minutes. After 3 washes with distilled water, slides were fullyair-dried on a slide warmer, cleared in xylene and coverslipped withDPX. Fluorojade C positive cells were counted for each region in bothhemisphere, by a FV 1000MPE Olympus confocal microscope.

For IBA1/TNF-α double labelling, sections were incubated 48 hours withIBA1 antibody (polyclonal goat anti-IBA1 1:200, Abcam, USA) and TNF-αantibody (TNF-α polyclonal rabbit anti-TNF-α 1:800, Abbiotec, USA).After PBS washing, the sections were incubated with secondary antibodyfor IBA1 while three-step detection was used to increase the signal ofTNF-α by biotin-conjugated IgG (IgG (H+L) Biotin-Goat anti rabbit 1:500,Invitrogen, USA) and streptavidin-fluorescein (1:200, Vector, UK).

Qualitative and quantitative analyses for IBA1 and TNFα were performedusing a FV 1000MPE, Olympus confocal laser scanning microscope. Z-seriesimages were processed by ImageJ 1.47v and volume of colocalized elementswas measured by Imaris 7.4.2 as follows: for each dataset, acolocalization channel was automatically composed by the software. Inthe final stacks, a region of interest for each brain region (CA1, CA3,DG and Cortex) per hemisphere of each animal was chosen, and volume ofthe elements of interest was calculated, summed and expressed asvolume/μm3.

As shown in FIG. 14A, after mTBI injury, a strong increase in the numberof Fluoro-Jade C positive neurons was observed in all areas examined(CA1, CA3, DG for Hippocampus, and lateral cortex) as compared tocontrols (p<0.05 for CA1; p<0.001 for CA3, DG and CTX; FIG. 14A, andFIGS. 14B, 14C, and 14D, and 14E, respectively). Treatment with PT302 atthe dose of 0.6 mg/kg counteracted mTBI-induced neurodegeneration in allthe areas examined (p<0.01 in CA3 and DG, FIGS. 14C and 14D; p<0.05 inCTX and CA1, FIGS. 14E and 14B), while the PT302 dose of 0.12 mg/kgshowed a significant effect in CA3 region (p<0.05).

As shown in FIG. 15A, following mTBI injury, IBA1 immunoreactivity wasincreased as compared to vehicle control, in all the analyzed regions(p<0.05 for CA1; p<0.001 for CA3, DG and CTX). In the control group,microglial cells displayed a resting morphology with a small soma, longand thin processes (FIG. 15A). After mTBI injury microglia showed anactivated morphology, characterized by a larger body with shorter andthicker processes (FIG. 15A). PT302 at both doses inhibited microglialactivation: PT302 0.6 mg/kg resulted effective in all the brain regions(p<0.001 in CTX; p<0.001 in CA1 and CA3; p<0.05 in DG).

Immunoreactivity for the pro-inflammatory cytokine TNF-α increased inIBA1+ cells in mTBI-lesioned group in all the analyzed areas (p<0.05 inDG; p<0.01 in CA1; p<0.001 in CA3 and cortex; FIGS. 15D, 15B, 15C, and15E, respectively). Administration of PT302 at the doses of 0.6 and 0.12mg/kg reduced the levels of IBA1/TNF-α IR colocalization volume in bothhippocampus and cortex.

Specific Embodiments

An aspect of the present disclosure provides a method for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprises: administering to thesystemic blood circulation of the subject a therapeutically effectiveamount of neuroprotective polypeptide by a controlled-releaseformulation or a device providing a sustained release or delivery of theneuroprotective polypeptide, wherein the neuroprotective polypeptideincludes at least one neuroprotective polypeptide selected from thegroup consisting of GLP-1, exendin-4, or a therapeutically effectiveGLP-1 or exendin-4 analogue, wherein the neuroprotective polypeptidebinds to and activates a receptor that binds at least one of GLP-1,exendin-4, or a combination thereof; and wherein the controlled-releaseneuroprotective formulation or sustained release of the neuroprotectivepolypeptide enhances the delivery and/or uptake of the neuroprotectivepolypeptide across a blood-brain barrier (BBB) of the subject to atleast a portion of the central nervous system (CNS) relative to a rapidrelease formulation of the neuroprotective peptide.

Another aspect of the present disclosure provides a method of treating asubject with a central nervous system (CNS)-related disease or reducingat least one symptom of a CNS-related disease in a subject in needthereof. The method comprises: administering to the systemic bloodcirculation of the subject a therapeutically effective amount of aneuroprotective polypeptide by a controlled-release formulation or adevice providing a sustained release or delivery of a neuroprotectivepolypeptide, wherein the neuroprotective polypeptide includes at leastone neuroprotective polypeptide selected from the group consisting ofGLP-1, exendin-4, or a therapeutically effective GLP-1 or exendin-4analogue, wherein the neuroprotective polypeptide binds to and activatesa receptor that binds at least one of GLP-1, exendin-4 or a combinationthereof; and wherein the controlled-release neuroprotective formulationor a device enhances the delivery of the neuroprotective polypeptideacross a blood-brain barrier (BBB) of the subject to at least a portionof the central nervous system (CNS) relative to a rapid releaseformulation of the neuroprotective polypeptide.

An aspect of the present disclosure provides a method for delivering aneuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprising administering acontrolled-release formulation to the systemic blood circulation of thesubject including at least one neuroprotective polypeptide selected fromthe group consisting of GLP-1, exendin-4, or a therapeutically effectiveGLP-1 or exendin-4 analogue, wherein the neuroprotective polypeptidebinds to and activates a receptor that binds at least one of GLP-1,exendin-4, or a combination thereof, and the controlled-releaseneuroprotective formulation enhances the delivery and/or uptake of theneuroprotective polypeptide across a blood brain barrier (BBB) of thesubject to at least a portion of the central nervous system (CNS)relative to a rapid release formulation of the neuroprotectivepolypeptide.

In any aspect or embodiment described herein, the controlled-releaseformulation is a long acting formulation of the neuroprotectivepolypeptide.

In any aspect or embodiment described herein, the controlled-releaseformulation further comprises a biodegradable polymer with a specificviscosity, and a coating material so that bioavailability and sustainedrelease of an effective amount of the neuroprotective polypeptide iseffectuated for a sufficient period (e.g., without an initial burst,such as a detrimental initial burst, of the active ingredient).

In any aspect or embodiment described herein, the controlled-releaseneuroprotective formulation comprises: a controlled-release microspherethat includes a core with the neuroprotective polypeptide and abiodegradable polymer; and a coating layer that coats the core.

In any aspect or embodiment described herein, the long actingformulation comprises a depot formulation for sustained release of theneuroprotective polypeptide.

In any aspect or embodiment described herein, the long actingformulation comprises a composition for sustained release of theneuroprotective polypeptide.

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation alleviates at least onesymptom of at least one CNS-related condition in the subject

In any aspect or embodiment described herein, the CNS-related conditionis selected from the group consisting of Parkinson's disease (PD),traumatic brain injury (TBI), multiple sclerosis, drug addiction,alcohol addiction, neurodegenerative conditions, inflammation of abrain, Alzheimer's disease (AD), multiple system atrophy, Huntington'sdisease, chronic traumatic encephalopathy, motor neuron diseases (e.g.,amyotrophic lateral sclerosis, spinal cord injury, spinocerebellarataxia (SCA), spinal muscular atrophy (SMA)), vascular dementia,dementia with Lewy bodies (DLB), mixed dementia, frontotemporaldementia, Creutzfeldt-Jakob disease, normal pressure hydrocephalus, or acombination thereof.

In any aspect or embodiment described herein, administering acontrolled-release neuroprotective formulation comprises injecting thecontrolled-release neuroprotective formulation.

In any aspect or embodiment described herein, injecting thecontrolled-release neuroprotective formulation is a subcutaneousinjection.

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation results in a steady-stateplasma concentration of the neuroprotective polypeptide that is in arange of about 50 to about 4500 pg/mL.

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation results in a cumulativeincrease in the neuroprotective polypeptide concentration in thecerebrospinal fluid (CSF), the brain or a combination thereof in thesubject.

In any aspect or embodiment described herein, the neuroprotectivepolypeptide concentration in the CSF is within the range of about 5 toabout 400 pg/mL.

A further aspect of the present disclosure provides a method of treatinga subject with a central nervous system (CNS)-related disease orreducing at least one symptom of a CNS-related disease in a subject inneed thereof. The method comprising administering to the systemic bloodcirculation of the subject a therapeutically effective amount of acontrolled-release neuroprotective formulation including at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue,wherein the neuroprotective polypeptide binds to and activates areceptor that binds at least one of GLP-1, exendin-4 or a combinationthereof, and the controlled-release neuroprotective formulation enhancesthe delivery of the neuroprotective polypeptide across a blood brainbarrier (BBB) of the subject to at least a portion of the centralnervous system (CNS) relative to a rapid release formulation of theneuroprotective polypeptide.

In any aspect or embodiment described herein, the controlled-releaseformulation is a long acting formulation of the neuroprotectivepolypeptide.

In any aspect or embodiment described herein, the controlled-releaseformulation further comprises a biodegradable polymer with a specificviscosity and coating materials, having bioavailability and sustainedrelease of the neuroprotective polypeptide in an effective concentrationfor a certain period (e.g., without an initial burst, such as adetrimental initial burst, of the active ingredient).

In any aspect or embodiment described herein, the controlled-releaseneuroprotective formulation comprises: a controlled-release microspherethat includes a core with the neuroprotective polypeptide and abiodegradable polymer; and a coating layer that coats the core.

In any aspect or embodiment described herein, the long actingformulation comprises a depot formulation for sustained release of theneuroprotective polypeptide.

In any aspect or embodiment described herein, the long actingformulation comprises a composition for sustained release of theneuroprotective polypeptide.

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation alleviates at least onesymptom of at least one CNS-related condition in the subject.

In any aspect or embodiment described herein, the CNS-related conditionis selected from the group consisting of Parkinson's disease (PD),traumatic brain injury (TBI), multiple sclerosis, drug addiction,alcohol addiction, neurodegenerative conditions, inflammation of abrain, Alzheimer's disease (AD), multiple system atrophy, Huntington'sdisease, chronic traumatic encephalopathy, motor neuron diseases (e.g.,amyotrophic lateral sclerosis, spinal cord injury, spinocerebellarataxia (SCA), spinal muscular atrophy (SMA)), vascular dementia,dementia with Lewy bodies (DLB), mixed dementia, frontotemporaldementia, Creutzfeldt-Jakob disease, normal pressure hydrocephalus, or acombination thereof.

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation comprises injecting thecontrolled-release neuroprotective formulation to the subject.

In any aspect or embodiment described herein, injecting thecontrolled-release neuroprotective formulation to the subject is asubcutaneous injection.

In any aspect or embodiment described herein, administering thecontrolled-release formulation results in a steady-state plasmaconcentration of the neuroprotective polypeptide that is in a range ofabout 50 to about 4500 pg/mL.

In any aspect or embodiment described herein, administering thecontrolled-release formulation results in a cumulative increase in theneuroprotective polypeptide concentration in at least one of thecerebrospinal fluid (CSF), the brain, or a combination thereof.

In any aspect or embodiment described herein, the formulation isadministered once every 7 to 21 days (e.g., once every 7, 8, 9, 10, 11,12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 days).

In any aspect or embodiment described herein, the formulation isadministered a second time about 7 to about 21 days (e.g., once everyabout 7, about 8, about 9, about 10, about 11, about 12, about 13, about14, about 15, about 16, about 17, about 18, about 19, about 20, or about21 days) after the previous administration.

In any aspect or embodiment described herein, the percent change in theneuroprotective polypeptide concentration in the plasma is no greaterthan about 30% when the formulation is re-administered within about 28days (e.g., within about 21 or about 14 days) of a previous formulationadministration.

An additional aspect of the disclosure provides a method for deliveringa neuroprotective polypeptide to at least a portion of a central nervoussystem (CNS) of a subject. The method comprises: providing a sustaineddelivery to the systemic blood circulation of the subject at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue,wherein the neuroprotective polypeptide binds to and activates areceptor that binds at least one of GLP-1, exendin-4, or a combinationthereof; and wherein the controlled-release neuroprotective formulationenhances the delivery and/or uptake of the neuroprotective polypeptideacross a blood brain barrier (BBB) of the subject to at least a portionof the central nervous system (CNS) relative to a rapid releaseformulation of the neuroprotective peptide.

An further aspect of the disclosure provides a method of treating asubject with a central nervous system (CNS)-related disease or reducingat least one symptom of a CNS-related disease in a subject in needthereof. The method comprises: providing a sustained delivery to thesystemic blood circulation of the subject at least one neuroprotectivepolypeptide selected from the group consisting of GLP-1, exendin-4, or atherapeutically effective GLP-1 or exendin-4 analogue, wherein theneuroprotective polypeptide binds to and activates a receptor that bindsat least one of GLP-1, exendin-4 or a combination thereof; and whereinthe controlled-release neuroprotective formulation enhances the deliveryof the neuroprotective polypeptide across a blood brain barrier (BBB) ofthe subject to at least a portion of the central nervous system (CNS)relative to a rapid release formulation of the neuroprotectivepolypeptide.

In any aspect or embodiment described herein, providing the sustainedrelease neuroprotective polypeptide or polypeptides administering theneuroprotective polypeptide or polypeptides via a device (e.g., a pump,a mini-pump, an osmotic pump, an osmotic delivery device, an infusionpump, an intravenous administration device, a peristaltic pump, aminiature infusion pump, or the like).

In any aspect or embodiment described herein, the percent change in thesteady-state neuroprotective polypeptide concentration in the plasmaafter steady-state is achieved is no greater than about 80% (e.g., nogreater than about 50% or no greater than about 40%) when theformulation is administered (e.g., when administered once every 7 to 28days, or once every 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20,21, 22, 23, 24, 25, 26, 27, or 28 days).

In any aspect or embodiment described herein, the neuroprotectivepolypeptide or polypeptides is administered via a device (e.g., a pump,a mini-pump, an osmotic pump, an osmotic delivery device, an infusionpump, an intravenous administration device, a peristaltic pump, aminiature infusion pump, or the like).

In any aspect or embodiment described herein, the neuroprotectivepolypeptide or polypeptides is administered at a rate of about 1pM/kg/min to about 30 pM/kg/min (e.g., about 3 pM/kg/min to about 17.5pM/kg/min).

In any aspect or embodiment described herein, administering thecontrolled-release neuroprotective formulation or providing a sustaineddelivery of the neuroprotective polypeptide alleviates at least onesymptom of at least one CNS-related condition in the subject.

In any aspect or embodiment described herein, administering thecontrolled-release formulation or providing the sustained release of theneuroprotective polypeptide results in a steady-state plasmaconcentration of the neuroprotective polypeptide that is in a range ofabout 50 to about 4500 pg/mL.

In any aspect or embodiment described herein, administering thecontrolled-release formulation or providing the sustained release of theneuroprotective polypeptide results in a cumulative increase in theneuroprotective polypeptide concentration in at least one of thecerebrospinal fluid (CSF), the brain, or a combination thereof.

In any aspect or embodiment described herein, the neuroprotectivepolypeptide concentration in the CSF is within the range of about 10 toabout 400 pg/mL.

In any aspect or embodiment described herein, the ratio of thesteady-state polypeptide concentration in the CFS to the plasma is inthe range of about 0.1% to about 5%.

In any aspect or embodiment described herein, the exendin-4 analogue isrepresented by Chemical Formula I or its pharmaceutically acceptablesalt:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 Xaa27 Xaa28-Z₁,   (Chemical Formula I)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala, or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, or a C1-C10straight chain or branched alkanoyl;

Xaa22 is Ala, Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

Xaa27 is Ala or Lys;

Xaa28 is Ala or Asn; and

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂,

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, or N-alkylalanine, Xaa39 is Ser, or Tyr (e.g.Ser), and

Z₂ is —OH, or —NH₂,

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, Xaa26, Xaa27, and Xaa28 are Ala; and    -   when Xaa1 is His, Arg, or Tyr, at least one of Xaa3, Xaa4, and        Xaa9 is Ala.

In any aspect or embodiment described herein, the exendin-4 analogue isrepresented by Chemical Formula II or their pharmaceutically acceptablesalts:

Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 X₁-Z₁,   (Chemical Formula II)

wherein:

Xaa1 is His, Arg, Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl;

Xaa2 is Ser, Gly, Ala, or Thr;

Xaa3 is Ala, Asp, or Glu;

Xaa4 is Ala, Norval, Val, Norleu, or Gly;

Xaa5 is Ala or Thr;

Xaa6 is Ala, Phe, Tyr, or naphthylalanine;

Xaa7 is Thr or Ser;

Xaa8 is Ala, Ser, or Thr;

Xaa9 is Ala, Norval, Val, Norleu, Asp, or Glu;

Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;

Xaa11 is Ala or Ser;

Xaa12 is Ala or Lys;

Xaa13 is Ala or Gln;

Xaa14 is Ala, Leu, Ile, pentylglycine, Val, or Met;

Xaa15 is Ala or Glu;

Xaa16 is Ala or Glu;

Xaa17 is Ala or Glu;

Xaa19 is Ala or Val;

Xaa20 is Ala or Arg;

Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, C1-C10 straightchain or branched alkanoyl, or cycloalleyl-alkanoyl;

Xaa22 is Phe, Tyr, or naphthylalanine;

Xaa23 is Ile, Val, Leu, pentylglycine, tert-butylglycine, or Met;

Xaa24 is Ala, Glu, or Asp;

Xaa25 is Ala, Trp, Phe, Tyr, or naphthylalanine;

Xaa26 is Ala or Leu;

X1 is Lys Asn, Asn Lys, Lys-NHε-R Asn, Asn Lys-NHε-R, Lys-NHε-R Ala, AlaLys-NHε-R, wherein R is Lys, Arg, a C1-C10 straight chain or branchedalkanoyl, or cycloalkylalkanoyl;

Z₁ is —OH, —NH₂, Gly-Z₂, Gly Gly-Z₂, Gly Gly Xaa31-Z₂, Gly Gly Xaa31Ser-Z₂, Gly Gly Xaa31 Ser Ser-Z₂, Gly Gly Xaa31 Ser Ser Gly-Z₂, Gly GlyXaa31 Ser Ser Gly Ala-Z₂, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36-Z₂, GlyGly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z₂, Gly Gly Xaa31 Ser Ser Gly AlaXaa36 Xaa37 Xaa38-Z₂, or Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38Xaa39-Z₂;

Xaa31, Xaa36, Xaa37, and Xaa38 are independently selected from the groupconsisting of Pro, homoproline, 3Hyp, 4Hyp, thioproline, N-alkylglycine,N-alkylpentylglycine, and N-alkylalanine, Xaa39 is Ser or Tyr; and

Z₂ is —OH or —NH₂,

provided that:

-   -   no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,        Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,        Xaa21, Xaa24, Xaa25, and Xaa26 are Ala; and    -   when Xaa1 is His, Arg, Tyr, or 4-imidazopropionyl, at least one        of Xaa3, Xaa4, and Xaa9 is Ala.

In any aspect or embodiment described herein, the neuroprotectivepolypeptide is selected from the group consisting of SEQ ID NOS: 1-55.

Each documents referred to herein is incorporated herein by reference.Except in the Examples, or where otherwise explicitly indicated, allnumerical quantities in this description specifying amounts ofmaterials, and the like, are to be understood as modified by the word“about”. It is to be understood that the upper and lower amount, range,and ratio limits set forth herein may be independently combined.Similarly, the ranges and amounts for each element of the disclosure canbe used together with ranges or amounts for any of the other elements.

Those skilled in the art will recognize, or be able to ascertain usingno more than routine experimentation, many equivalents to the specificembodiments and methods described herein. Such equivalents are intendedto be encompassed by the scope of the following claims.

It is understood that the detailed examples and embodiments describedherein are given by way of example for illustrative purposes only, andare in no way considered to be limiting to the disclosure. Variousmodifications or changes in light thereof will be suggested to personsskilled in the art and are included within the spirit and purview ofthis application and are considered within the scope of the appendedclaims. For example, the relative quantities of the ingredients may bevaried to optimize the desired effects, additional ingredients may beadded, and/or similar ingredients may be substituted for one or more ofthe ingredients described. Additional advantageous features andfunctionalities associated with the systems, methods, and processes ofthe present disclosure will be apparent from the appended claims.Moreover, those skilled in the art will recognize, or be able toascertain using no more than routine experimentation, many equivalentsto the specific embodiments of the disclosure described herein. Suchequivalents are intended to be encompassed by the following claims.

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1. A method for delivering a neuroprotective polypeptide to at least aportion of a central nervous system (CNS) of a subject, the methodcomprising: administering to the systemic blood circulation of thesubject a therapeutically effective amount of the neuroprotectivepolypeptide by a controlled-release formulation or a device providing asustained release of the neuroprotective polypeptide, wherein theneuroprotective polypeptide includes at least one neuroprotectivepolypeptide selected from the group consisting of GLP-1, exendin-4, or atherapeutically effective GLP-1 or exendin-4 analogue, wherein theneuroprotective polypeptide binds to and activates a receptor that bindsat least one of GLP-1, exendin-4, or a combination thereof; and whereinthe controlled-release neuroprotective formulation or sustained releaseof the neuroprotective polypeptide enhances the delivery and/or uptakeof the neuroprotective polypeptide across a blood-brain barrier (BBB) ofthe subject to at least a portion of the central nervous system (CNS)relative to a rapid release formulation of the neuroprotective peptide.2. The method according to claim 1, wherein the controlled-releaseformulation is a long acting formulation of the neuroprotectivepolypeptide.
 3. The method according to claim 1, wherein thecontrolled-release formulation further comprises a biodegradable polymerwith a specific viscosity, and a coating material so thatbioavailability and sustained release of an effective amount of theneuroprotective polypeptide is effectuated for a sufficient period. 4.The method of according to claim 1, wherein the controlled-releaseneuroprotective formulation comprises: a controlled-release microspherethat includes a core with the neuroprotective polypeptide and abiodegradable polymer; and a coating layer that coats the core.
 5. Themethod according to claim 2, wherein the long acting formulationcomprises a depot formulation for sustained release of theneuroprotective polypeptide.
 6. The method according to claim 2, whereinthe long acting formulation comprises a composition for sustainedrelease of the neuroprotective polypeptide.
 7. A method of treating asubject with a central nervous system (CNS)-related disease or reducingat least one symptom of a CNS-related disease in a subject in needthereof, the method comprising: administering to the systemic bloodcirculation of the subject a therapeutically effective amount of aneuroprotective polypeptide by a controlled-release formulation or adevice providing a sustained release of the neuroprotective polypeptide,wherein the neuroprotective polypeptide includes at least oneneuroprotective polypeptide selected from the group consisting of GLP-1,exendin-4, or a therapeutically effective GLP-1 or exendin-4 analogue,wherein the neuroprotective polypeptide binds to and activates areceptor that binds at least one of GLP-1, exendin-4 or a combinationthereof; and wherein the controlled-release neuroprotective formulationor the sustained release of the neuroprotective polypeptide enhances thedelivery of the neuroprotective polypeptide across a blood-brain barrier(BBB) of the subject to at least a portion of the central nervous system(CNS) relative to a rapid release formulation of the neuroprotectivepolypeptide.
 8. The method according to claim 7, wherein thecontrolled-release formulation is a long acting formulation of theneuroprotective polypeptide.
 9. The method according to claim 7, whereinthe controlled-release formulation further comprises a biodegradablepolymer with a specific viscosity and coating materials, havingbioavailability and sustained release of the neuroprotective polypeptidein an effective concentration for a certain period.
 10. The methodaccording to claim 7, wherein the controlled-release neuroprotectiveformulation comprises: a controlled-release microsphere that includes acore with the neuroprotective polypeptide and a biodegradable polymer;and a coating layer that coats the core.
 11. The method according toclaim 8, wherein the long acting formulation comprises a depotformulation for sustained release of the neuroprotective polypeptide.12. The method according to claim 8, wherein the long acting formulationcomprises a composition for sustained release of the neuroprotectivepolypeptide.
 13. The method according to claim 3, wherein thebiodegradable polymer is selected from the group consisting ofpolylactide (PLA), polyglycolide (PGA), poly(lactide-co-glycolide)(PLGA), polyorthoester, polyanhydride, polyhydroxybutyric acid,polycaprolactone, and polyalkylcarbonate, a copolymer or a simplemixture of two or more selected the polymer group, a copolymer of thepolymer and polyethylenglycol (PEG), or a polymer-sugar complex where asugar is coupled with the polymer or the copolymer.
 14. The methodaccording to claim 1, wherein administering the controlled-releaseneuroprotective formulation comprises injecting the controlled-releaseneuroprotective formulation to the subject.
 15. The method according toclaim 14, wherein injecting the controlled-release formulation to thesubject is a subcutaneous injection.
 16. The method according to claim1, wherein the controlled-release formulation is administered asubsequent time about 7 to about 21 days (e.g., once every about 7,about 8, about 9, about 10, about 11, about 12, about 13, about 14,about 15, about 16, about 17, about 18, about 19, about 20, or about 21days) after the previous administration.
 17. The method according toclaim 1, wherein the device provides the sustained release of thecontrolled-release formulation.
 18. The method of claim 1, wherein thedevice is a pump (e.g., a pump, a mini-pump, an osmotic pump, an osmoticdelivery device, an infusion pump, an intravenous administration device,a peristaltic pump, a miniature infusion pump, or the like).
 19. Themethod of claim 1, wherein the neuroprotective polypeptide isadministered by the device at a rate of about 1 pM/kg/min to about 30pM/kg/min (e.g., about 3 pM/kg/min to about 17.5 pM/kg/min).
 20. Themethod according to claim 1, wherein administering the neuroprotectivepolypeptide to the systemic blood circulation alleviates at least onesymptom of at least one CNS-related condition in the subject.
 21. Themethod according to claim 20, wherein the CNS-related condition isselected from the group consisting of Parkinson's disease (PD),traumatic brain injury (TBI), multiple sclerosis, drug addiction,alcohol addiction, neurodegenerative conditions, inflammation of abrain, Alzheimer's disease (AD), multiple system atrophy, Huntington'sdisease, chronic traumatic encephalopathy (CTE)motor neuron diseases(e.g., amyotrophic lateral sclerosis, spinal cord injury,spinocerebellar ataxia (SCA), spinal muscular atrophy (SMA)), vasculardementia, dementia with Lewy bodies (DLB), mixed dementia,frontotemporal dementia, Creutzfeldt-Jakob disease, normal pressurehydrocephalus, or a combination thereof.
 22. The method according toclaim 1, wherein administering the controlled-release formulation orproviding the sustained release of the neuroprotective polypeptide by adevice results in a steady-state plasma concentration of theneuroprotective polypeptide that is in a range of about 50 to about 4500pg/mL.
 23. The method according to claim 1, wherein administering thecontrolled-release formulation or providing the sustained release of theneuroprotective polypeptide by a device results in a cumulative increasein the neuroprotective polypeptide concentration in at least one of thecerebrospinal fluid (CSF), the brain, or a combination thereof.
 24. Themethod according to claim 1, wherein the neuroprotective polypeptideconcentration in the CSF is within the range of about 10 to about 400pg/mL.
 25. The method according to claim 1, wherein the ratio of thesteady-state polypeptide concentration in the CFS to the plasma is inthe range of about 0.1% to about 5%.
 26. The method of according toclaim 1, wherein the exendin-4 analogue is represented by ChemicalFormula I or its pharmaceutically acceptable salt:Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 Xaa27 Xaa28-Z₁,   (Chemical Formula I) wherein: Xaa1 is His, Arg,Tyr, Ala, Norval, Val, Norleu, or 4-imidazopropionyl; Xaa2 is Ser, Gly,Ala, or Thr; Xaa3 is Ala, Asp, or Glu; Xaa4 is Ala, Norval, Val, Norleu,or Gly; Xaa5 is Ala or Thr; Xaa6 is Ala, Phe, Tyr, or naphthylalanine;Xaa7 is Thr or Ser; Xaa8 is Ala, Ser, or Thr; Xaa9 is Ala, Norval, Val,Norleu, Asp, or Glu; Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;Xaa11 is Ala or Ser; Xaa12 is Ala or Lys; Xaa13 is Ala or Gln; Xaa14 isAla, Leu, Ile, pentylglycine, Val, or Met; Xaa15 is Ala or Glu; Xaa16 isAla or Glu; Xaa17 is Ala or Glu; Xaa19 is Ala or Val; Xaa20 is Ala, orArg; Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, or a C1-C10straight chain or branched alkanoyl; Xaa22 is Ala, Phe, Tyr, ornaphthylalanine; Xaa23 is Ile, Val, Leu, pentylglycine,tert-butylglycine, or Met; Xaa24 is Ala, Glu, or Asp; Xaa25 is Ala, Trp,Phe, Tyr, or naphthylalanine; Xaa26 is Ala or Leu; Xaa27 is Ala or Lys;Xaa28 is Ala or Asn; and Z₁ is —OH, —NH₂, Gly-Z2, Gly Gly-Z2, Gly GlyXaa31-Z₂, Gly Gly Xaa31 Ser-Z2, Gly Gly Xaa31 Ser Ser-Z2, Gly Gly Xaa31Ser Ser Gly-Z2, Gly Gly Xaa31 Ser Ser Gly Ala-Z2, Gly Gly Xaa31 Ser SerGly Ala Xaa36-Z2, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z2, Gly GlyXaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38-Z2, or Gly Gly Xaa31 Ser Ser GlyAla Xaa36 Xaa37 Xaa38 Xaa39-Z2, Xaa31, Xaa36, Xaa37, and Xaa38 areindependently selected from the group consisting of Pro, homoproline,3Hyp, 4Hyp, thioproline, N-alkylglycine, N-alkylpentylglycine, orN-alkylalanine, Xaa39 is Ser, or Tyr (e.g. Ser), and Z₂ is —OH, or —NH₂,provided that: no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9,Xaa10, Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20,Xaa21, Xaa24, Xaa25, Xaa26, Xaa27, and Xaa28 are Ala; and when Xaa1 isHis, Arg, or Tyr, at least one of Xaa3, Xaa4, and Xaa9 is Ala.
 27. Themethod according to claim 1, wherein the exendin-4 analogue isrepresented by Chemical Formula II or their pharmaceutically acceptablesalts:Xaa1 Xaa2 Xaa3 Xaa4 Xaa5 Xaa6 Xaa7 Xaa8 Xaa9 Xaa10 Xaa11 Xaa12 Xaa13Xaa14 Xaa15 Xaa16 Xaa17 Ala Xaa19 Xaa20 Xaa21 Xaa22 Xaa23 Xaa24 Xaa25Xaa26 X₁-Z₁,   (Chemical Formula II) wherein: Xaa1 is His, Arg, Tyr,Ala, Norval, Val, Norleu, or 4-imidazopropionyl; Xaa2 is Ser, Gly, Ala,or Thr; Xaa3 is Ala, Asp, or Glu; Xaa4 is Ala, Norval, Val, Norleu, orGly; Xaa5 is Ala or Thr; Xaa6 is Ala, Phe, Tyr, or naphthylalanine; Xaa7is Thr or Ser; Xaa8 is Ala, Ser, or Thr; Xaa9 is Ala, Norval, Val,Norleu, Asp, or Glu; Xaa10 is Ala, Leu, Ile, Val, pentylglycine, or Met;Xaa11 is Ala or Ser; Xaa12 is Ala or Lys; Xaa13 is Ala or Gln; Xaa14 isAla, Leu, Ile, pentylglycine, Val, or Met; Xaa15 is Ala or Glu; Xaa16 isAla or Glu; Xaa17 is Ala or Glu; Xaa19 is Ala or Val; Xaa20 is Ala orArg; Xaa21 is Ala, Leu, or Lys-NHε-R, wherein R is Lys, Arg, C1-C10straight chain or branched alkanoyl, or cycloalleyl-alkanoyl; Xaa22 isPhe, Tyr, or naphthylalanine; Xaa23 is Ile, Val, Leu, pentylglycine,tert-butylglycine, or Met; Xaa24 is Ala, Glu, or Asp; Xaa25 is Ala, Trp,Phe, Tyr, or naphthylalanine; Xaa26 is Ala or Leu; X₁ is Lys Asn, AsnLys, Lys-NHε-R Asn, Asn Lys-NHε-R, Lys-NHε-R Ala, Ala Lys-NHε-R, whereinR is Lys, Arg, a C1-C10 straight chain or branched alkanoyl, orcycloalkylalkanoyl; Z₁ is —OH, —NH₂, Gly-Z2, Gly Gly-Z2, Gly GlyXaa31-Z₂, Gly Gly Xaa31 Ser-Z2, Gly Gly Xaa31 Ser Ser-Z2, Gly Gly Xaa31Ser Ser Gly-Z2, Gly Gly Xaa31 Ser Ser Gly Ala-Z2, Gly Gly Xaa31 Ser SerGly Ala Xaa36-Z2, Gly Gly Xaa31 Ser Ser Gly Ala Xaa36 Xaa37-Z2, Gly GlyXaa31 Ser Ser Gly Ala Xaa36 Xaa37 Xaa38-Z2, or Gly Gly Xaa31 Ser Ser GlyAla Xaa36 Xaa37 Xaa38 Xaa39-Z2; Xaa31, Xaa36, Xaa37, and Xaa38 areindependently selected from the group consisting of Pro, homoproline,3Hyp, 4Hyp, thioproline, N-alkylglycine, N-alkylpentylglycine, andN-alkylalanine, Xaa39 is Ser or Tyr; and Z₂ is —OH or —NH₂, providedthat: no more than three of Xaa3, Xaa4, Xaa5, Xaa6, Xaa8, Xaa9, Xaa10,Xaa11, Xaa12, Xaa13, Xaa14, Xaa15, Xaa16, Xaa17, Xaa19, Xaa20, Xaa21,Xaa24, Xaa25, and Xaa26 are Ala; and when Xaa1 is His, Arg, Tyr, or4-imidazopropionyl, at least one of Xaa3, Xaa4, and Xaa9 is Ala.
 28. Themethod according to claim 1, wherein the neuroprotective polypeptide isselected from the group consisting of SEQ ID NOS: 1-55.
 29. The methodaccording to claim 2, wherein the controlled-release formulation furthercomprises a biodegradable polymer with a specific viscosity, and acoating material so that bioavailability and sustained release of aneffective amount of the neuroprotective polypeptide is effectuated for asufficient period.
 30. The method according to claim 3, wherein the longacting formulation comprises a composition for sustained release of theneuroprotective polypeptide.
 31. The method according to claim 8,wherein the controlled-release formulation further comprises abiodegradable polymer with a specific viscosity and coating materials,having bioavailability and sustained release of the neuroprotectivepolypeptide in an effective concentration for a certain period.
 32. Themethod according to claim 4, wherein the biodegradable polymer isselected from the group consisting of polylactide (PLA), polyglycolide(PGA), poly(lactide-co-glycolide) (PLGA), polyorthoester, polyanhydride,polyhydroxybutyric acid, polycaprolactone, and polyalkylcarbonate, acopolymer or a simple mixture of two or more selected the polymer group,a copolymer of the polymer and polyethylenglycol (PEG), or apolymer-sugar complex where a sugar is coupled with the polymer or thecopolymer.
 33. The method according to claim 9, wherein thebiodegradable polymer is selected from the group consisting ofpolylactide (PLA), polyglycolide (PGA), poly(lactide-co-glycolide)(PLGA), polyorthoester, polyanhydride, polyhydroxybutyric acid,polycaprolactone, and polyalkylcarbonate, a copolymer or a simplemixture of two or more selected the polymer group, a copolymer of thepolymer and polyethylenglycol (PEG), or a polymer-sugar complex where asugar is coupled with the polymer or the copolymer.
 34. The methodaccording to claim 10, wherein the biodegradable polymer is selectedfrom the group consisting of polylactide (PLA), polyglycolide (PGA),poly(lactide-co-glycolide) (PLGA), polyorthoester, polyanhydride,polyhydroxybutyric acid, polycaprolactone, and polyalkylcarbonate, acopolymer or a simple mixture of two or more selected the polymer group,a copolymer of the polymer and polyethylenglycol (PEG), or apolymer-sugar complex where a sugar is coupled with the polymer or thecopolymer.
 35. The method of claim 8 wherein the device is a pump (e.g.,a pump, a mini-pump, an osmotic pump, an osmotic delivery device, aninfusion pump, an intravenous administration device, a peristaltic pump,a miniature infusion pump, or the like).
 36. The method of claim 17,wherein the device is a pump (e.g., a pump, a mini-pump, an osmoticpump, an osmotic delivery device, an infusion pump, an intravenousadministration device, a peristaltic pump, a miniature infusion pump, orthe like).
 37. The method of claim 8, wherein the neuroprotectivepolypeptide is administered by the device at a rate of about 1 pM/kg/minto about 30 pM/kg/min (e.g., about 3 pM/kg/min to about 17.5 pM/kg/min).38. The method of any of claim 17, wherein the neuroprotectivepolypeptide is administered by the device at a rate of about 1 pM/kg/minto about 30 pM/kg/min (e.g., about 3 pM/kg/min to about 17.5 pM/kg/min).39. The method of claim 18, wherein the neuroprotective polypeptide isadministered by the device at a rate of about 1 pM/kg/min to about 30pM/kg/min (e.g., about 3 pM/kg/min to about 17.5 pM/kg/min).